Archive December 2002 III, No. 12

The Art of Fast OR Turnover

A nurse managers beat-the-clock approach for preparing the OR for the next surgical case.

Cheryl Stanley, RN

BIO

Turnover time is the time from when one patient leaves the OR suite until the next patient enters. Obviously, the less time it takes to turn a room over, the more OR time is available, which translates into a potential for increased revenue. Here are 10 strategies we employ at our multi-specialty facility to keep our OR turnaround times at or beneath the unwritten but universally accepted industry standard of 15 minutes.

1. Develop surgical specialists.
Although our OR teams are cross-trained and can do all cases in our facility, each staff member specializes in certain areas (such as cataract, orthopedic and ENT cases) and works the majority of her schedule in the same type of cases. This way, the employee learns the tendencies of the surgeon and his cases - not only the exact equipment and supplies needed, but also key factors such as where the surgeon prefers everything positioned and how long the case is likely to last.

2. Employ instrument and scrub techs.
To ensure maximum efficiency, we employ an instrument tech to work in the OR. She makes sure all the instruments are cleaned and ready for the case. Similarly, although we only have two general ORs, we have three scrub techs on hand. This helps speed cases along if extra hands are needed and also gives an extra pair of hands for quick room turnover. Any additional staffing costs we incur are made back in revenue generated by keeping the ORs busy.

3. Clean up as a team.
After each case is completed, all available members of the OR team work together to clean the room. Communication is crucial. The circulating nurse notifies the instrument tech and the PACU nurse that the case is finishing. That way, the instrument tech is ready at the door and the recovery nurse is ready for report and assuming care for the patient. As soon as the case is done, the OR staff gets to work. The circulating nurse takes down all the suction and anesthesia tubing, an OR tech wipes down the cart and takes out the trash, and the instrument tech collects and cleans the instruments.

4. Prepare for the next case.
After clean-up, the scrub tech starts setting up a sterile OR, breaking task only to assist in prepping the next patient as needed. As the patient is being intubated or sedated, the tech re-scrubs and prepares to assist the physician. Meanwhile, while the final set-up details are completed, the anesthesiologist transfers the patient from pre-op to the OR.

Average Turnaround Times



Here are some of the average OR turnaround times for different procedures that we perform at our facility:
  • Postpartum tubals


  • 11-14 minutes
  • Cataract surgery


  • 7-10 minutes
  • hernia repair


  • 14-16 minutes
  • Knee arthroscopy


  • 13-16 minutes
  • Tonsil and adenoid surgery


  • 11-15 minutes
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