Before implementing widespread changes, test the effectiveness of
the new turnover approach in several ORs involving a variety of cases.
Over a 3-month span in 2018, Dr. Cerfolio and his team tested process
improvements over 7 days in 35 ORs involving 42 cases. The process
improvement team met weekly to review the data and identify barri-
ers to greater efficiency. At the end of the trial period, they compared
the results to historic data that involved the same surgeons perform-
ing the same cases, and found they cut turnover times by more than
half. Anecdotally, the process improvement team noticed turnover
times were shorter when surgeons were present in the room between
cases, perhaps because staff saw they were ready to get started on the
next case as soon as the patient arrived.
Stick-to-itiveness
Don't get discouraged if turnover times don't decrease immediately.
Ms. Rock says her team's efforts reduced average room cleaning times
from 15 minutes to 8 minutes, but overall turnover times — defined as
wheels out for the previous patient to wheels in for the next patient —
have lagged because of issues occurring outside of the ORs. Still, she
says, it's important to begin making the initial efforts that will eventual-
ly lead to positive change.
You might even realize some unexpected benefits along the way. A
surgeon working down the hall from where Dr. Cerfolio conducted his
process improvement project saw what was going on and expressed
interest in making the same improvements in his ORs. The surgeon
worked to decrease his turnover times from 36 minutes to 32 minutes
and clocked 6 turnovers that took less than 20 minutes, the first time
he reached that mark in his 30-year career. "When people see things
getting better, they want to be part of it," says Dr. Cerfolio. "The halo
effect is real."
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