I once had a conversation with a surgeon about his frustration with a hospital due to slow turnover. He lamented that, at worst, it could be an hour or more. He shared that their process included a turnover team that came in for both the surgical and anesthesia staff while the staff assigned to the room took the time to break.
I know from many conversations with surgeons that inefficient turnovers impact their perception of the facility as a whole.
I look at turning over like a dance. When choreographed well, it can be really efficient. Here are some ideas to make sure your turnovers don’t look like a room without rhythm.
An all hands on deck approach. The most effective turnovers occur when there are enough people to do the dance, and communication is key. The more the merrier. In a large center I know, they overhead announce “Turnover to Room 1”. Every appropriate available staff member changes gears and jumps in.
Dancing in the right spot. As important as all hands on deck is, have the licensed staff prioritize the tasks only they can do, like medications and patient interviews. I can mop a mean floor, but may be better utilized to be interviewing the next patient.
Anesthesia prep is key. Work with the anesthesia team to be ready for the day. They may need to pick for their cases the day prior as well to prevent between case delays.
Sharps. Once counts are complete and correct, safely discard the sharps first. Saves dancing around them when linens and trash are collected.
Instruments. If you notify your central tech that the case is complete, they can retrieve the instruments and trays used. Leaves the tech in play more quickly for the room turnover.
Communication. When possible, notify PACU when you are coming out so they can be on deck to receive your patient. Having a PACU bay and nurse ready will result in a more efficient hand off. I’ve been both the PACU nurse having to stop education mid stream to receive a new patient, as well as the circulator helping set up a bay quickly so that we can hand off. Let Pre-Op know you are coming out as well. They can make sure the patient is ready to roll. The circulator can call an assigned person to notify the team. Depending on your center, a phone call, text or announcement to someone who can coordinate the communication can get everyone in motion.
Check readiness. As much as a quick turnover rocks, so does a efficient one. The tech verifies all instruments and supplies are open or ready, and the bed area is checked for all positioning and equipment needs. Do a connection check as well; if it plugs in, make sure all the components are in place. Bovie pad limbo under the drapes is never fun.
I hope your turnovers are like a well rehearsed line dance. Comment and share or e mail me at firstname.lastname@example.org if you have any great tips that work. Have a great week!