IS FEWER BETTER? Some say the only thing worse than a turnover team with not enough able-bodied bodies is one with too many.Many hands make light work, but some say less is more when it comes to turning a room over after surgery. "Sometimes more people is not better," says Cynthia Loomis, RN, CNOR, of Carroll Hospital Center in Westminster, Md. "We used to assign each staff to a particular task when they arrived to do turnover: tables, lights, bed. But it didn't work. It was chaos and then you kept asking, 'Did you get the lights? Did you get the ?'"
Ms. Loomis favors a leaner approach to readying the OR for the next case: deploying 2 environmental services techs to work in tandem with the RN and tech from that room. "It's also helpful," she says, "to have an anesthesia tech to take care of the anesthesia end of things."
A 10-minute turnover is the goal at most surgical centers, but there aren't always enough people to roll up their sleeves and pitch in, say facility leaders who favor an all-hands-on-deck approach. "At times employees forget that everyone should assist with room turnover," says Margaret Chappell, RN, MS, CASC, a senior vice president of operations with Ambulatory Surgical Centers of America. "Our housekeeping attendants do a good job, but we need more of them," says a nurse manager.
One of the things that stood out in our survey of nearly 100 nurse managers about the challenges of OR turnovers is that staff will sometimes go to great lengths to, ahem, avoid cleanup duty. A favorite stall tactic of nurses is milking the time it takes to chart a case. Surgeons who use the computer in the OR when the RN circulator needs to close out the case and call for housekeeping unwittingly delay turnover and the start of the next case. "Physicians need to carry a laptop or the OR needs 2 computers," says a respondent.
