Improving on-time surgical starts through a perioperative stop and huddle

Background

Punctuality in procedure start times is a critical component of operating room efficiency. The first case on-time start (FCOTS) metric refers to the number of first cases of a day that start on time. Delays in FCOTS, by leading to future case delays, have a detrimental impact on perioperative operations and result in worsened patient care, increased health care costs and decreased patient satisfaction. Despite the importance of timely FCOTS, many attempts to improve FCOTS have failed. We designed a quality improvement project to drive punctual FCOTS.

Methods

To increase FCOTS, perioperative services implemented a mandatory team meeting time of 15 min before the scheduled procedure start time and six other associated processes to improve FCOTS. This 0715-bedside arrival for all team members enabled a full preoperative huddle. All required preoperative duties were expected to be completed before this 0715-huddle time.

Results

The implementation of a 0715 mandatory pre-operative huddle improved the FCOTS significantly by 10 % with a sustained increase of 7 %. Furthermore, this increase has been sustained for over a year, well above the 90th percentile benchmark of healthcare systems using our electronic health record and earned our system a first-place national ranking for FCOTS.

Conclusion

A multi-disciplinary team approach and regimented huddle times prior to surgical starts helped improve the percentage of FCOTS across our healthcare system.