Surgery Management Improvement Group - Hospital and Operating Room Management Services
Surgery Management Improvement Group - Hospital and Operating Room Management Services
Surgery Management Improvement Group - Hospital and Operating Room Management Services
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Surgery Management Improvement Group - Hospital and Operating Room Management Services
  • Comprehensive Operating Room Management Consulting Services . . .

    . . . include surgery process and system assessment, cost manage-
    ment, facility evaluation and design, surgery information and bench-
    marking analyses, operating room schedule planning and administration and interim contract management.
    Learn More about Gail Nogle Photography
  • Experience Matters.

    SMI Group brings over 60 years experience to clients coast to coast. We can successfully assist you in every phase of the surgery process, including improving relationships between staff, surgeons & referring physicians. We deliver marketable, cost-efficient programs with the latest technology and techniques.
    Missing a deadline can be costly.
  • Answers. Coast-to-Coast

    Word of our success gets around – and so do we! SMI Group is proud of it's track record, literally from coast-to-coast. Regardless of where you are in North America, let SMI Group demonstrate how we can improve your hospital operation and bottom line.
    Coast-to-Coast Solutions from SMI Group
  • Let's sit down & discuss how SMI Group can help.

    Give us a call and let's talk about your hospital and operating room issues. We'll crunch some numbers and start your plan.
    Don't put it off another day.
    Call 734-327-4000 and talk with John, Sue and Dorothy.
    Let's sit down & discuss how Surgery Management Improvement Group can help
  • Succession Planning for the Operating Room

    SMI Group provides the tools and assistance to plan the management succession for your operating room. Our process identifies key roles, management capabilities of existing staff, and cultivates qualified internal candidates to become tomorrow's perioperative leaders.
    Let's talk about your financial future

Rapid Operating Room Turnover

Improving Surgeons' Personal Productivity

Surgery Management Group

What do we mean by "Turnaround" Time?   Surgery Management Improvement Group - Rapid Operating Room Turnover

  • For Nurses, Turnaround Time usually means from one patient leaving the Operating Room to the next patient entering the OR
  • For Anesthesiologists, Turnaround Time usually means from the time a patient is transported to PACU and given report to the next patient's anesthetic induction
  • For Surgeons, Turnaround Time means from the closure of one patient's surgical wound to the next patient's incision
  • While all these definitions are correct from the perspectives of the different clinicians, the one we will work with in this Module is that of the surgeon
Surgery Management Group

Why such an emphasis on Turnaround (Turnover) Time?   Surgery Management Improvement Group - Rapid Operating Room Turnover

  • Turnover Time represents lost revenue-generating opportunity for the Surgeon as well as the Hospital and Anesthesiologist.
  • Once in practice, the only thing physicians are really selling is their timeā€¦..
    - and hospitals can be notorious about wasting physicians' time!
  • Improving Turnover Time is a major opportunity to increase the clinicians' personal productivity and optimize hospitals' income.
Surgery Management Group

Typical Turnaround Process   Surgery Management Improvement Group - Rapid Operating Room Turnover

Typical Turnaround Process
  • Activities are performed sequentially
    - Nursing brings previously completed case instruments to decontamination area, then
    - Picks instruments/supplies for next case, then
    - Nursing completes room set up, then
    - Anesthesia visits patient in Pre-op Holding, then
    - Patient is transported into OR, etc., etc.
  • Rather than in parallel
Surgery Management Group

Improved Turnaround Process   Surgery Management Improvement Group - Rapid Operating Room Turnover

Typical Turnaround Process
Surgery Management Group

Improved Turnaround Time - Impact   Surgery Management Improvement Group - Rapid Operating Room Turnover

Typical Turnaround Process

Between current time and benchmark potential can yield significant opportunities for increased business as well as physician satisfaction.



Inpatient Case Time Analysis (Minutes)

Typical Turnaround Process

Potential Impact on Increased Business

  • Potential Savings: 1,581 hours/year
  • Potential Added Cases/Year: 543 cases

Potential Impact on OR Availability

  • Equivalent Rooms: 1.10
  • Rooms that could accommodate additional volume
Surgery Management Group

How Can We Improve Our Turnover Time?   Surgery Management Improvement Group - Rapid Operating Room Turnover

  • The "secret" to improving turnover time is to create a Case Process Map - a definition for all the "actors" on the Operating Room stage of who should be doing what, and when.
  • Creating a multidisciplinary team (OR staff, Surgeons, Anesthesia Providers) to clearly identify roles during case set-up and break-down and to determine which activities may safely be conducted simultaneously.
  • Adherence to that Case Process Map by all clinicians on all cases.
Surgery Management Group

Shared Definition of "Start" Time   Surgery Management Improvement Group - Rapid Operating Room Turnover

Typical Turnaround Process
Surgery Management Group

Example Case Process Map   Surgery Management Improvement Group - Rapid Operating Room Turnover

Typical Turnaround Process
Surgery Management Group

Efficiencies to Consider Incorporating into Case Process Map   Surgery Management Improvement Group - Rapid Operating Room Turnover

  • Discontinue full body draping for minor procedures performed on head/neck and/or limb
  • Create smaller instrument sets for minor procedures
  • Discontinue between-case mopping on "bloodless" cases
  • Standardize instrument sets (e.g., limited "doctor-specific" trays)
  • Regularly review instrument trays' contents to eliminate seldom/never used items
  • Leave instruments in their trays on the back table (Instrumentation requires a significant labor time when laid out individually)
  • Regularly review pack contents and preference cards eliminating never used items to facilitate back table management, decrease set up and tear down times and promote cost containment.
  • Assign ancillary personnel to assist with:
    - room cleaning
    - patient positioning, catheterization, tourniquet placement, skin prep, limb holding, etc.
    - specialized equipment hook ups and disconnects
    - picking supplies/instruments for following cases while current case underway
    - anesthesia equipment set up
  • Minimize documentation time. Collapse and combine as many chart documents as possible. Create an integrated perioperative record for pre-, intra-, and postoperative documentation.
  • Surgery Management Group

    Decreasing TOTAL Turnaround Time   Surgery Management Improvement Group - Rapid Operating Room Turnover

    Typical Turnaround Process
SERVICES "SNAPSHOT"
Surgery Management Improvement Group - Operating Room Scheduling Management
Operating Room Scheduling Management: Operating room planning is a complex task where numerous resources must be synchronized in order to achieve efficiency. Surgeon availability, operating team scheduling, patient related information (i.e. estimated operating time, priority and diagnosis), equipment, and support resources must all be carefully orchestrated. (learn more)
Surgery Management Improvement Group - Hospital &  Operating Room Management Services
Surgery Management Improvement Group - Anesthesiology Program Consulting
Anesthesiology Program Consulting: A well-defined, coordinated anesthesiology program is essential to a cost and operationally effective, marketable operating room. Areas of evaluation and development expertise include: Program Evaluation and Design, Anesthesiologist/CRNA/ Resident Care Team Process Evaluation, Surgeon Nursing Interrelationship, (learn more)
Surgery Management Improvement Group - Hospital &  Operating Room Management Services
Surgery Management Improvement Group - Ambulatory Surgery Center & Program Development
Ambulatory Surgery Center & Program Development: SMI Group provides hospital and surgery center consulting services that provide ambulatory surgery program development & management solutions. We help you retain & grow Ambulatory Market Share while improving expected surgery outcomes. (learn more)
Surgery Management Improvement Group - Hospital &  Operating Room Management Services
SMI Group, Inc.
P.O. BOX 7590
Ann Arbor, MI 48107-7590
734-327-4000