A Nurse-Driven Plan to Diminish First-Case Operating Room Delays

Area of Science:

• Perioperative Nursing
• Healthcare Operations Management
• Quality Improvement Science

Background:

• First case start times in the operating room (OR) are critical for surgical workflow efficiency.
• Delays in the first case start impact subsequent procedures, patient flow, and resource utilization.
• Understanding factors contributing to OR delays is essential for improving patient care and operational performance.

Purpose of the Study:

• To investigate the impact of a nurse-driven plan on reducing delays in the first case start time within the operating room.
• To identify and describe factors associated with delays in achieving on-time first case starts.
• To analyze the rationale behind preoperative process delays.

Main Methods:

• A posttest-only quasi-experimental design was employed to assess the effect of time-bound preoperative process steps on first case delays.
• Data were collected via an audit form by an observer, recording target times, times met, delay durations, and reasons for delay.
• The study examined both controllable and uncontrollable factors contributing to delays.

Main Results:

• Thirty-one percent of patients (31 out of 99) experienced delays in reaching the operating room for their first case.
• Identified delay factors included both controllable issues, such as staff tardiness, and uncontrollable circumstances, like patients requiring restroom use before surgery.
• The study provided insights into the frequency and nature of first case delays.

Conclusions:

• The findings support the systematic identification and evaluation of preoperative process steps to mitigate first case start delays.
• Adjusting activities based on identified bottlenecks and factors is crucial for enhancing OR efficiency.
• Recognizing and planning for both controllable and uncontrollable delay factors can proactively prevent disruptions in the surgical schedule.