Turnover time between cases - page 2
I'm curious to know what other facilities consider to be an "appropriate" turnover time between cases. How long between the time you leave your patient in PACU until you roll your next patient into... Read More
Feb 10, '08Quote from scrubbythe last time i had a surgeon complain about turnover times, when one person (me) has to do the entire room after a c-section - complete top to bottom, or area and baby wamer corner, picking up after "quadraplegic" ob/circulating nurses and anesthesiologists who couldn't hit the trash can they were leaning against with anything in their hands, wiping up after them, doing the instruments, trash, linens, wiping down everything else, mopping, making both beds, restocking both areas, gathering up the next case, setting it around, opening and setting it up - i handed him the mop, and said "you want faster turnovers, please feel free to pitch in." he stared at me for about 5 seconds and started mopping. he watched everything i did and i never got any complaints after that.in eyes the turnover time can be about 7 minutes. for general surgery about 20-30 minutes. ortho can take much longer because of all the setting up we do.
the surgeons recently tried complaining about slow turnover times. we proved to them that our times are pretty average, from statistics in an aorn journal.
the one thing that seemed to make the most difference is when the ob/circulating nurse (who leaves the room with the patient to recover her and is never seen again) knows to use her "free" time during the case to pick up after herself, clean up the baby warmer area when the baby has gone to nicu, or is in the arms of the father at the head of the or table and is completely stable, and generally make sure things are pretty tidy when she leaves the room. these are generally former or nurses, and are rare and treasured! even so, turnover of 20-30 minutes is hard to reduce, since one person must do the whole job. not even when i had my table broken down and started to clean the room - with the attending's permission - while the attending, and/or the resident, and medical student did the final closure on the patient.
can't honestly say i miss that part - but i do miss my job since i had to leave recently due to a number of reasons, not the least of which was massive budget cuts and staff reductions, which "reduced" me right out of my job. the fact that i am also home recovering from a second rotator cuff repair surgery in january (first one this past july) which will keep me down and out for another 5-6 months at least doesn't help anything either.
Feb 10, '08We dont have a set turnover time like many are mentioning, but I think one thing the surgeons forget is everything we do have to do after they leave. They put in the last suture, tear off their gown and go. We have to apply the bandage, clean up the pt, take off the drapes. Then we have to move the pt over and anesthesia wake them up (which we all know can take 5-20 + mins). Then take them to recovery, finish charting, take extra equipment out of the room, take our instruments to be cleaned/turned over, mop and wipe down the room, put fresh linens on, and then grab the next case and get ready to go. By this time, the dr's are in the lounge playing games on the computer or watching youtube.
If there's a team already waiting to turn over the dr, then it's no problem, but when the same team is on a lineup, it's going to be anywhere from 15-30 mins or so before the next pt is wheeled back. At least thats how it is for us at the hospital. I dont know how surgery centers are set up to turn over quicker, as I've never worked at one. We do our best, however, and pray we have an extra minute to go to the bathroom!
Feb 12, '08I work at a same day surgery facility.... however I don't know if we can be called that because half of our patients are inpatient...oy... and we are mostly an ortho hospital so we do lots of totals.... well anyway... we generally have a great team and we try to reduce turnover time as much as possible... so we try to keep it under ten minutes. Usually there is a team of people that stream in after the patient leaves to clean up and open the next case... so by the time I take the patient to the recovery room, I can go to admitting and get the next patient right away. Even for difficult ortho turnovers which we do A LOT... we can go from general surgery to a total hip within minutes. For ENT, we usually have two RN's in the room so when one nurse brings to recovery, the other gets the patient so turnovers are even under three minutes. The other day, day we finished 14 ENT procedures by 1400, one surgeon had six cases (4 total joints 2 scopes) done by 1600 by flipping two rooms, and one room had three total joints and one scope and finished by 1500, with start of the day at 0700.