Starting Cases on time: Don’t let the pans soak…

We can’t always get the surgeon there on time, but we can take steps to make sure we are ready when they get there.  Here are a few tips that may help all that dirty work seem a little easier and off to a clean start:

•  Interview the patient prior to physician arrival. Murphy’s law will prove true and the patient will have to use the bathroom one more time, the patient or family has questions, or the consent is missing a key element. Better to have resolved these issues prior to retrieving the patient.
• Have everything ready for the case. Pick cases prior to the day before surgery.  Picking the case means instruments and implants, too.  I have been stuck without a correct sized implant when the staff assumed it is in consignment or I assumed the rep was bringing it.  If the rep is bringing an implant, supply or instrument, I call the day before (even if we have already discussed it) just to be sure.
• Signing off on “The Pick”.  You may want to create check off form.  I like using brightly colored paper with three lines:  supplies, instruments, implants.  The same paper can be used to communicate any arrangements made as well; ie:  Joe the rep is bringing the bone putty.  The staff member completing the pick signs the form.   Have someone double check that all are done at the end of the day and report off prior to leaving for the day.

• Accountability is key.  All OR staff pick cases for the next day.  No one leaves until cases are picked, which means the early room down and staff with down time pick.  Before a staffer leaves, they report to somebody that the pick is complete.  And they can’t soak the pans!

Soaking the pans is my analogy for fairly sharing the work.  When I was a teenager, my family had a dishwasher…my brother and me.  We both hated doing dishes with a passion.  As you can imagine, the dishes were always ahead of whatever social plans we may have had for the evening.  So, one of us would wash the dishes as quickly as possible, and put water and soap in the pan(s), so when asked if the dishes were done, we would say “yes” leaving the soaking pan for the other person.  If I left a soaking pan for my brother he would then have to wash, he would also then find a way re-pay me. It was war… Needless to say it still gets brought up as legendary fodder at the holiday table.  So, to keep the OR peaceful, make sure that everybody picks and that all the “pans are washed” at the end of the day.

And as for those tardy docs, I welcome any suggestions!