Team effort vs. assigned tasks saves time
A work environment that focuses on teamwork rather than specific job responsibilities is the key to the low turnover time posted by St. George (UT) Surgical Center in the Performance Management Study of Knee Arthroscopy with Meniscectomy, says Ken Summerhays, RN, CNOR, director of nursing.
The study was offered by the Institute for Quality Improvement, a division of the Association for the Accreditation of Ambulatory Health Care in Wilmette, IL. While these tips are just business as usual for his staff, they are all activities that result in turnover times of only 20 minutes between cases, explains Summerhays:
• The scrub tech and circulator prepare the room while the anesthesiologist interviews the patient.
• The anesthesiologist brings the patient to the room for the circulator to speak with him or her while the scrub tech finishes setup.
• The circulator reviews the patient assessment prepared by the pre-op nurse and verifies the procedure, right or left leg, and patient identity. The patient marks the correct knee with a skin marking pen, then the nurse uses the history and physical or information from the anesthesia pre-op questionnaire to double-check on which knee the procedure is to be performed, says Summerhays. The pre-op staff share any problems directly with the OR staff.
• When the surgeon closes, the scope is passed off to the circulator so the disinfection process can begin seven to 10 minutes before the end of the case.
• The anesthesiologist and circulator take the patient to the post-anesthesia care unit while the scrub tech cleans and flashes the instruments, if needed. Whoever if available first — the circulator, the scrub tech, or the pre-op nurse — brings supplies for the next case into the room. Whichever staff member is free opens the supplies.
• The circulator gives a brief report and returns to the OR to help with cleanup and setup.
• The circulator mops the floor and wipes down the furniture, the table, the operating stand, buckets, and the IV poles. The scrub tech, pre-op holding staff, and anesthesiologist help if available.
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