First-Procedure Delays Linked to Tardy Surgeons

Timely arrival of surgeons increases initial on-time start rate from 24 to 80 percent

TUESDAY, April 12 (HealthDay News) -- Operating room (OR) first-procedure delays can be significantly reduced if the surgeons arrive on time for their procedures, according to a report published in the April issue of the AORN Journal.

Maria Fezza, R.N., C.N.O.R., and Gina Bledsoe Palermo, R.N., from the New York University Langone Medical Center in New York City, and members of the On Time Start Committee examined each phase of the patients perioperative process in 110 procedures, to identify the cause of first-procedure delays in the OR. Surgeons' late arrivals were established as the main cause of delays, and a physician accountability initiative was developed to reduce late arrivals. Team members arrived an hour before the start of surgery to prepare the OR and patient. Surgeons were asked to document their arrival times and report this daily to the chiefs of surgery and anesthesia. Daily e-mail reminders were sent asking surgeons to arrive 20 minutes before scheduled procedures.

The researchers found that there was a 13 percent decrease in the number of first-procedure delays within two weeks of implementation of the initiative. The chiefs of surgery and anesthesia adhered to the time requests and the chiefs of surgery personally spoke to surgeons who arrived late. With continued overall improvement, first-procedure delays decreased as the initial on-time start rate increased from 24 to 80 percent.

"These simple solutions became the unlikely method of changing the culture of late starts in the OR," the authors write. "The initiatives put in place were so effective that they are now permanent policy."

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