"I was shocked to observe that the more people who were in the
room, the less effective they were because no one had any idea what
the others had already cleaned," she says.
Now, 6 team members — an anesthesia tech, circulating nurse,
scrub tech and 3 members of the hospital's housekeeping team —
descend on rooms with assigned cleaning roles. Ms. Rock says
appointing position-specific cleaning roles makes it clear who will
clean what during turnovers. If a member of the turnover team is
called away or the task is taking longer than expected, colleagues
know where their help is needed.
3. Create cleaning carts.
The team at University of Iowa
Hospitals developed cleaning supply carts — 9 to cover the facility's
32 ORs — that wheel gloves, surface disinfectants, garbage and linen
bags, mops and buckets to the point of use. "We included everything
our turnover teams would need — including items they often had to
leave the room to grab," says Ms. Rock.
4. Switch to a surface disinfectant with a shorter
dwell time.
The turnover team at Iowa further reduced turnover
times by switching surface disinfection products from a quaternary
ammonium product with a dwell time of 10 minutes to an accelerated
hydrogen peroxide disinfectant with a dwell time of 1 minute.
5. Track your progress.
Post weekly room turnover data —
average turnover time, the week's best turnover time — so staff can
track their progress and aim to better their times. "Change is difficult
when surgical teams are used to the routine of room turnovers," says
Dr. Cerfolio. "Once they see the value in efficient room turnovers,
you'll be able to sustain and scale process improvement."
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