STAFFING
assigning patients to pre-op beds. (Never mind the emergent cases that
would further confuse matters.)
The only way to know which nurses were getting which patients ready
was to flip through charts. We didn't like the helter-skelter process, and
patients deserved a calmer scene before heading into surgery.
To reach a solution, we first created a team that included representa-
tives from every aspect of perioperative care. We tried to eliminate as
many roadblocks as possible, and didn't accept answers that involved
adding staff members.
Match pre-op beds with ORs
Key for us was making use of a secondary pre-op area that contains 8
beds, bumping our total number of pre-op beds to 18. Now, the periop-
erative lead or charge nurse previews the next day's surgical schedule
and matches pre-op beds with ORs — 2 pre-op beds are assigned to
each OR — based on the number and types of cases and expected pro-
cedure times. In our case, pairings of 18 pre-op beds staffed by
assigned nurses feed patients to one of 9 ORs throughout the day. We
give high-volume ORs beds in opposite sides of the pre-op area so as
not to impede patient flow. As you can see in the photo, we note the
assignments and layout of the pre-op area on a dry erase board for
quick reference by the entire surgical team.
Much smoother patient flow
Among the new system's noticeable improvements:
• Smarter staffing.
There was a lot of concern about how we could
improve patient flow without increasing manpower. We've found that
organized assignments eliminate staff running around to locate
patients or seek answers to clinical care questions, so the same num-
ber of nurses can accomplish more by working smarter, not harder.
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