Synergy at work: using quality improvement to reduce OR delay starts

1. Our clinical service department, perioperative care, had several long-standing issues that needed resolution. Many seemed to revolve around OR delay starts, yet data were necessary to validate the scope of the issue. A systematic program review was planned to evaluate services delivered. 2. A systematic analysis of delay starts revealed that the following factors were involved: anesthesia delays (including insertion of invasive lines), inadequate space or staff to meet needs, incomplete workup or patient preparation, scheduling changes due to incomplete scheduling information or room/equipment not ready, physician not immediately available, patient delays, and emergency cases in progress. 3. An interdisciplinary work team was recruited to assist in resolving this identified factor. The overall issue of delay starts, the focus of the work team, and the plan of approach were reviewed. A problem was identified and corrected. Twelve months later, a formal review of delay starts demonstrated an 80% reduction in delays from scheduling information.