Durable improvements in efficiency, safety, and satisfaction in the operating room

Area of Science:

• Healthcare Management
• Surgical Operations
• Patient Safety

Background:

• Operating room (OR) staff faced a retention crisis due to mandatory overtime and unpredictable hours after a hospital transition.
• This crisis threatened the OR's operational viability and the institution's capacity to deliver care.
• Balancing productivity, efficiency, patient safety, and staff satisfaction in the OR is critical.

Purpose of the Study:

• To report on changes implemented to improve OR efficiency and safety.
• To address and resolve a critical staff-retention crisis within the OR.
• To foster a supportive environment for surgeons and OR staff while enhancing operational performance.

Main Methods:

• Evaluated University of Alabama at Birmingham University Hospital OR data from fiscal years 2004-2006.
• Assessed case volumes, operational OR numbers, on-time case starts, and adverse events.
• Used registered nurse hires and staff departures as indicators of staff satisfaction.

Main Results:

• Implemented strategies included new block time policies, use of traveling nurses, and voluntary, incentive-based overtime.
• Mandatory nursing education time was scheduled weekly, and National Patient Safety Goals were enforced.
• Observed increases in operations per year, on-time starts, and RN hires, alongside decreases in adverse events, delays, and staff departures.

Conclusions:

• Change, though challenging, is vital for clinical activities facing impairment.
• Data-driven changes were developed and implemented to sustain the OR environment in an academic center.
• Successful retention of human resources and restoration of a supportive environment for patients, doctors, and staff were achieved.