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Measuring Consistent Staffing in the Operating Room

Posted by Kartik Bhatt on Mar 18, 2021 8:39:16 AM
Kartik Bhatt
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Many hospital administrators across the country receive repeated complaints from surgeons who feel that there is almost no consistency to the staff members who are assigned to their procedures. An unfamiliar face in the operation room (OR) can be a stressor to the surgeon, and staff members not knowing a surgeon’s habits can throw off the cadence and fluidity of a procedure. Verification and confirmation between the surgeon and the team in the room are integral at key times during procedures (time outs, counts, choice of implants, specimen, and final procedure description and diagnosis), but needing to verbalize every step of the way (outside of these integral times) to ensure the team is constantly in sync can be distracting to the surgeon.

Although hospital leaders can sometimes be skeptical of physician complaints about unfamiliar staff, there is strong evidence that consistent staffing in the OR results in better clinical outcomes, reduced waste, and increased surgeon and staff satisfaction. It also increases operational efficiency, as seen through improved first case on-time starts, reduced room turnover times, and consistent case durations. Furthermore, research has shown that the patient’s perception of how well the surgical team worked together is one of the key drivers of patient satisfaction, as measured by HCAHPS or similar surveys. Stable teams can anticipate the needs of the surgeon, are familiar with specialty equipment, and are acutely aware of case needs, allowing them to operate as a well-oiled, cohesive unit. Additionally, as preference cards in many hospitals tend not to be accurate or reliable, stable OR teams’ in-depth institutional knowledge of surgeons’ routines and preferences can help to reduce the waste and delays associated with incorrectly picked supplies and instruments.

It is imperative to understand the methodologies required to build consistent teams so that nursing leadership can ensure that the appropriate staff are assigned to each team. Consistent OR teams can be created using a variety of methodologies, but one of the most successful methods is using surgical specialty. Staffing based on surgical specialty ensures that the staff in the room are knowledgeable about the procedures and the equipment that will be used in the rooms that they are assigned to. Surgeons and nursing leadership must work collaboratively to determine a reasonable definition of what constitutes a “consistent team”, how compliance should be measured, and when these teams can be provided (e.g. only on weekdays during primetime hours).

Despite the well-known benefits of stable OR teams, outdated charting practices make implementing these teams and accurately tracking their use a challenge at most hospitals. While hospitals are required to chart personnel entering and exiting a room, these personnel are seldom reconciled to their specific role (e.g. primary circulator, primary tech) in the procedure. As consistent teams are created at the role level, accurate charting and data reconciliation is a must.

Surgical Directions can help your organization build staffing teams based on surgical specialty, improve data entry and charting of the staff on each case, and track how often consistent staffing is provided to surgeons by the hospital. While tracking this staffing compliance is critical, it is also important to track the downstream effects of implementing specialty teams. Our team of clinical and analytics experts can help you quantify these improvements by taking a deep dive into your operational metrics and satisfaction surveys. Armed with best practices and accurate data, you’ll be well-equipped to tackle this challenge head on, increasing the quality of service provided at your facility.

Tags: Staff Productivity, Staff Optimization, analytics, OR Schedule