Successful ORs – with efficient patient throughput – are like orchestras. With everyone playing his or her part, with a good conductor leading them, harmony is not only achieved, it becomes the norm.
You may say your facility’s ORs resemble a cacophony instead of a symphony. But with a little fine-tuning and practice, patient throughput can become pitch-perfect.
The best players and conductors in the world still need something to make their music cohesive and orderly. In music, it’s a score. In an OR, it’s a comprehensive preanesthesia screening program (PAS). A PAS program will achieve maximum use of OR time and resources by:
Identifying abnormal conditions that could negatively affect a patient’s perioperative care
Addressing medical issues before the day of surgery
Minimizing surgery delays and cancelations and improving on-time starts
Reducing crisis on the day of surgery
Not only does a PAS program help the patient and OR logistics; it also benefits the facility by:
Increasing revenue and satisfaction by allowing surgeons to finish more cases in the same amount of time
Improving utilization and satisfaction of anesthesia providers and nursing staff
Reducing costs of routine testing that might not be necessary
Easing patient anxiety by making sure they and their families know how to prepare for the operation and recovery
To reap all the benefits for patients and medical centers, a comprehensive screening and preparation process should be put in place to maximize productivity. All this should happen before the day of surgery to individualize the plan of care, including identifying the potential for regional anesthesia and identifying options for pain and nausea control.
Best results on the day of surgery are achieved when patient preparation is limited to any final checks and tests that absolutely couldn’t be done beforehand. Running the OR schedule as planned (or preplanned, as it were) allows staff to anticipate and plan their workday. It also minimizes physician, anesthesia, and nurse downtime.
Obviously it may not be possible or even necessary to go through an extensive preanesthesia screening program for every patient. So which patients should be targeted? Every patient having elective surgery should complete the preoperative questionnaire giving details of his or her medical history and their current medical condition. An RN trained in the screening process will call the patient to review the questionnaire and complete the assessment. Then any clinic appointments, testing, and consultations based on the responses will be scheduled.
The Anesthesiology Department is responsible for the medical direction of the PAS program. That means it develops the questionnaire and testing guidelines; trains clinicians to identify patients whose cases need to be reviewed by anesthesia providers; and collaborates with surgeons, anesthesiologists, and nurses to make sure the program’s guidelines and testing criteria has everyone’s support. The Department of Surgery supports the program’s guidelines and processes. It trusts that the preanesthesia program is accountable for making sure medical preparation for surgery is thorough; it understands that quality, safety and productivity are the primary goals.
With the essential players working together, the precision of the OR improves and contributes to successful patient outcomes. Patients themselves are better prepared – both emotionally and medically – for their procedures. And good PAS program gives all involved the opportunity to achieve their best performances in the OR.