Knowledge Bank

Delays in surgery have a significant and compounding impact to OR efficiencies resulting in unused operating room time representing missed revenue generating opportunities. Delays can prolong the duration of a surgical case increasing a patient's risk for postoperative complications and prevent subsequent cases from timely entry to the OR. Reasons for delays are most frequently related to communication failures between members of the operating room team. The purpose of this quality improvement project was to implement an evidence-based checklist-guided pre-surgical huddle to decrease delays and increase OR efficiencies such as first case on-time starts (FCOTS), turnover time (TOT), and last case on-time end (LCOTE). During the 8-week project implementation period, 83% of the huddles were attended by all team members with cardiac fellows and nursing staff at 98%. With a pre-surgical huddle, the LCOTE cumulative deviation decline per day by 68 minutes resulted in a projected $435,000 opportunity cost savings. Specialty specific checklist guided pre-surgical huddles promoted teamwork, increased communication, and increased OR efficiencies.