When Every Minute Counts: Implementing a Preoperative Time-Based Target for Perioperative Nurses to Decrease...

Improving OR first-case on-time starts (FCOTS) is a multifactorial challenge for perioperative nurses and leaders seeking to improve efficiency. This article describes the implementation of a quality improvement project at a hospital-based ambulatory surgery center to decrease FCOTS delays, which did not allow the organization to meet its FCOTS adherence goal of 80% or higher, averaging 59% in 2023. Through the creation and adoption of standard work documents to reduce variability, nurses were given a preoperative time frame within which to complete the nursing components required to prepare a patient for the OR. When comparing intervention and baseline data after the three-month intervention period, a significant reduction in total minutes delayed was noted-from 1,422 to 799 minutes (P < .001)-as well as an improvement in FCOTS compliance to 82%. Estimated cost savings were $35,111 for the three-month intervention period, demonstrating that modifications to nursing workflows alone can improve perioperative efficiencies.