Archive February 2015 XVI, No. 2

Achieving World-Class Turnover Time

Help in the never-ending battle to shorten the time between wheels out to wheels in.

Jim Burger

Jim Burger, Senior Editor


turnover ALL FOR ONE At Arkansas Children's Hospital, the emphasis is on teamwork and accountability.

A Colorado hospital reduced average turnover time from 26 minutes to 20. How did they do it? The effort began with observation. What was costing turnover teams time? What efforts were being duplicated? What could be done better and faster? The idea, says Treena Dockery, MBA/HCM, CLM, process improvement consultant at University of Colorado Health, was to have a variety of stakeholders step back, observe everything about the process and try to identify waste, using lean techniques and principles. To broaden their perspective, they observed more than 10 cases over multiple shifts and at multiple times throughout the day at Poudre Valley Hospital in Fort Collins, Colo. Here's what they discovered:

1. Little things added up to big things. For example, patients moving from pre-op to the OR, and from the OR to the PACU were having different types and sizes of EKG leads, blood pressure cuffs and pulse oximeters attached and fully removed at every stop along the way. The solution was to create a series of adapters that made it possible to simply disconnect and reconnect patients as they moved from station to station. "Now, the blood pressure cuff stays on and rolls with the patient through the entire process," says Paul Higgins, BSN, RN, CNOR, business manager for perioperative services at Poudre Valley.

2. Duplication of effort is a big time-waster. One of the first things the observers saw was that communication had to improve. There had to be a better understanding of who was doing what. "We would wipe off the back table 3 times, given the opportunity," says Mr. Higgins. "We had to develop that standard work that someone was going to be wiping the horizontal and vertical surfaces, somebody else was going to be mopping the floor, and so on. Everyone had to know what their role was."

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