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Hospital Healing: How OR Efficiency Saves Lives

Maintaining a hospital operating room is a major expense for a health care organization. The equipment, medications and supplies are expensive, and staffing costs for the specialized professionals who work in the OR are also high. Many hospitals focus on efficiency to reduce or contain costs, but an equally important reason for OR efficiency is that it saves lives.

Time Matters
The longer a patient spends on the operating table, the greater the risk of complications. For example, blood clots, pneumonia and infections all increase with longer surgical times. Devices that are inserted into the patients body, such as intravenous and urinary catheters or endotracheal tubes, begin to cause damage to tissues if left in place for very long. A 2015 study from Tennessee published in the Journal of the American College of Surgeons found that the risk of postoperative infections in general and vascular surgery increased beginning with surgical times of 42 minutes or more.

Efficiency Lies in the Details
An efficient OR is one in which the operating room is laid out for maximum efficiency, all equipment is in good working order and the staff are well-trained. All of these things must happen before the operation commences. Staff training begins at hire and should continue indefinitely, as clinical knowledge, techniques and equipment change. Equipment must be cleaned and tested prior to the start of the operation and regular maintenance is required to ensure that a vital piece of equipment will function correctly when needed. In cases of equipment failure, a patient could be harmed by the equipment or the surgery might need to be stopped before treatment has been completed.

A Standardized Surgical Checklist
The World Health Organization notes that consistent use of surgical checklists helps to prevent operations that are performed on the wrong side, while the traditional count of supplies and instruments ensures items are not left inside a patient’s body. Soon after WHO first released the recommended checklist, a study of the eight pilot hospitals found that deaths and complications dropped by more than one-third. WHO notes that while many hospitals use some sort of checklist, even the best hospitals do not perform each step consistently, which is the key to success.

Teamwork Above All
Teamwork is a vital strategy to improve OR efficiency. In one study of a comprehensive team training program in Veterans Health facilities, the death rate dropped by 18 percent. The training program included surgeons, anesthesiologists, nurses, and associated OR health staff. The focus of the training program, reported in a 2010 issue of Seminars in Thoracic and Cardiovascular Surgery, was on changing the OR culture from one in which each well-meaning individual “did his thing” to a cohesive approach.

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