OR turnover times

[Qwiigley, BSN, MSN, DNP, RN, CRNA]

There is a big push this season to move to a 21 minute turnover time in the OR. (Wheels out to wheels in) My question is what is your average turnover time in your institution, (letting us know how many OR suites you have). How do you acheive this? Are there any exceptions?

In ESWL cases, my average yesterday was 12 min turnovers. But for a day full of general surgery (lap chole, appy, hernia etc) we are looking at around 30min turnovers. This is with MDAs doing the pre-ops while the CRNAs do the cases.

Our problems start when Environmental Services are in another room and delay cleaning our room or the nursing staff is still opening the case and don't like us bringing the patient in the room until they have "counted."

[amiandjim]

We have 9 operating rooms in our main hospital and four in our ambulatory surgery center. In the main, we generally have 15 minute turnover (at least, that is goal) and we do pretty well, I think. Our enviromental services staff and our anesthesia techs do a great job facilitating this. In addition, our OR staff is always willing to jump in and help clean the room so we can turnover more quickly. In our ASC, our turnover is 5 minutes, with very few exceptions. We do not have cleaning staff or anesthesia techs over there so it is just team work that gets it done.

[Leprechaun]

Hi Amiandjim,

Just read your post......and am feeling lots of frustration about this issue at the moment. I work in a large hospital with 20 ORs in the main OR and 8 in the outpatient center. The hospital recently hired some consultants to come in and find ways to save $$$. One of the new "rules" is a 25 min turnover in the main OR and an 18 min turnover in the Outpatient area. People's jobs are being threatened and pay is being docked for not meeting these new requirements. Everyone is panicked and frustrated right now. It feels like the hospital is more focused on numbers and $$$ than it is on the patients themselves. I fear that bad things are going to happen if this type of service continues.....

[loveanesthesia]

We have 12 OR on one site and 6 in another site. Turnover times are around 15-20 minutes. The techs start cleaning as soon as dressings are on, a safe quick wakeup for anesthesia, and there is no waiting to bring the patient into the room until the count is done. I walk directly from the PACU to the PSCU, meet the next patient and assess them, back to the OR to set up for the case. Often we have SRNAs, so then I have the SRNA go to PSCU assess the patient, I get the OR set up, and have the student fill me in. Usually I do get back to see the patient before they get in the OR. This depends on an anesthesia pre-assessment which we almost always have done. If that isn't done then it will slow the turnover time. Usually free OR staff help with the cleaning and opening of the rooms but there are not specific cleaning people. Sometimes you can't safely wake someone up and extubate in a few minutes, so then I just explain why it will take a little longer.

[Qwiigley, BSN, MSN, DNP, RN, CRNA]

Seems like if you have 5 cases scheduled and you cut off 10 min from your turn over time, you only gained 50 min. Right? Not enough time to add another case. Where is the money saving?

Yes, there are sometimes more cases, but not in every room and not every case is around an hour long. (actually most are not.)

JMHO

[remifentanil]

We have about 45 ORs.. the rate limiting step seems to be anyone BUT anesthesia. House keeping not having enough people to clean all rooms when they are done, residents up doing chores on the floors instead of marking the patient... OR nurses who MUST take a break between rooms....