Improving Operating Room Turnaround Times

Challenge

In 2019, the hospital faced a unique challenge: Case Tech workload affected their ability to prepare operating rooms for surgeries in a consistent and timely manner. Instead, nurses were required to assist with room turnover and ensuring Operating Rooms had critical supplies. As a result, surgeries were often delayed, causing a backup in the hospital’s surgery schedule. These delays also caused a drop in physician and nurse satisfaction. The Hospital’s Senior Leadership team approached Crothall Healthcare’s Environmental Services (EVS) team asking for help solving the issue. Crothall has a long-standing partnership with the hospital, providing EVS services to OLOL Regional Medical Center since 1997.

“The Perioperative Support Associates are a great group of people to work with, and I’ve been seeing their growth and willingness to help since they started. Patient care has improved since they started with us, and our patients leave our unit in a better condition than when they initially came down to us.”  — Linda Whall, BSN, RN, CNOR, and Director Main OR, OLOL Regional Medical Center

Solutions

The Crothall team worked with Our Lady of the Lake’s Lean Six Sigma team to create a hybrid position called Perioperative Support Associate (PSA). In January 2020, Crothall piloted a program with 10 PSAs and a dedicated hourly supervisor to support the primary surgery department. Unlike a Case Technician, who receives extensive observed competency training and works for the hospital, the responsibilities for the Crothall PSA position include:

• Assisting with transporting patients to the operating room and helping position them on the operating table.
• Taking blood specimens from the operating room to the laboratory.
• Providing surgical supplies to the operating room before surgery.
• After surgery, taking medical instruments to the Sterile Processing Services department.
• Transports and delivers medications within the OR areas (excluding controlled substances and IV chemotherapy drugs).
• Maintaining inventory of surgical supplies/equipment.

Due to the pilot’s success, there are now 18 PSAs plus an hourly supervisor supporting operating rooms in each of the hospital’s three patient towers. Because each associate must support multiple surgeries daily, PSAs are needed for shifts from 6:30 a.m. to 9 p.m. on weekdays and 7:30 a.m. to 4:00 p.m. on weekends.

PSAs receive specialized training, which provides them with higher starting pay and more opportunities for career advancement. Extensive training is paramount to the success of this program. Each new PSA and their supervisor must have 160 hours of training classes before beginning to work. The entire team has a total of more than 3,000 training hours.

Very soon the hospital saw the much needed decreases in operating room turnover times, keeping surgical schedules on time and bolstering physician and nurse satisfaction.

“It is an honor to work with the hospital’s leadership team, knowing they have the confidence in our capabilities to grow our partnership and build a unique service. From our end, it’s also highly satisfying to help our client improve its level of care and service while ensuring patients get the care they desperately need.” — Steve Oquin, Resident Regional Director of Operations, Crothall Healthcare

“The addition of PSAs has improved our image as well as the overall morale of our unit. They are fantastic team members who are always ready to pitch in and provide support in any way possible every day. They do a great job communicating with our staff and each other to ensure we are meeting the patient’s needs. They make rounds each morning with a cart to stock our rooms with Cavi Wipes, sheets, and chuck pads to ensure we are ready to turn over our rooms quickly and efficiently. They also make sure our blankets are stocked, and beds, stretchers, and the entire unit are clean and neat.” — Vicki Davis, RN, CNOR, RNFA OR Specialty Coordinator, General, Laparoscopic, Trauma, and Urological Surgery, OLOL Regional Medical Center

Results

• Enhanced teamwork and collaboration with the EVS team and caregivers, which has led to increased Surgeon and Nursing satisfaction.
• Improved engagement and retention of PSAs: 3 of 11 main surgery PSAs enrolled in the surgery tech certification program; Tower surgery PSA retention rate of 88%
• Saving nursing time and increasing patient safety by enabling nurses to spend more time focusing on patients.

Decreased OR turnover times, showing a 24% improvement over two years, and reducing costly and dissatisfying surgical delays.

“We have accomplished a lot during our 25-year partnership with OLOL Regional Medical Center. During this time, I am most proud of how we have worked alongside hospital leadership to create solutions that have elevated our service and the care OLOL Regional Medical Center provides to its patients and community. We look forward to growing our partnership and conquering other challenges as a team in the years ahead” — Mike Bahar, Senior Regional Director of Operations, Crothall Healthcare