Not the Arby’s dessert, silly! Turnovers in the operating room. This is the time it takes a surgeon to get back into the same operating room for his subsequent surgery. My partner, Dr. Steve Lantier, came up with a great idea years ago: ”let’s not have any turnovers.” What? This was one of the critical decisions made early on at our surgery center that has set us apart. This decision/goal has changed the way that operating rooms in Oklahoma City work. The pressure to emulate our model has been simply too much to bear for our competitors and hence their feeble attempts to match us come as no surprise, really.
Normally a surgeon finishes a surgery case then waits for the anesthesiologist to wake their patient up, the operating room to be cleaned, the instruments to be washed, the staff to take a break and for the anesthesiologist to anesthetize his next patient….and then for that patient to be “prepped,” or prepared for their procedure. Dr. Lantier said, “wait!” “Why not give the surgeon two operating rooms, two surgical crews and two anesthesiologists? Then the surgeon can go from room to room without waiting.” Keep in mind that the typical “turnover time” in a big hospital is about an hour. If a surgeon does five surgeries, there are four hours of turnover involved. When the surgeon does that same five cases at our facility, they just saved four hours. It is not uncommon for a surgeon to complete in 2 hours at our facility the same surgical caseload that would take 6-7 hours to complete at one of the big facilities.
“But wait a minute!” ”Didn’t you have to hire more people than you would have needed and don’t you have more expensive anesthesia staff on board to make this happen?” Yes and yes. We have committed to provide the best and most efficient service to the patients and surgeons even though it probably costs us money. Although, completing 7 hours of surgery in 2 hours frees the schedule up for more cases to be done, so maybe we are guilty of having spent capital to increase volume/profits. Probably. This “flipping” of the surgeons from room to room is, however, one of the early decisions that has made us the favorite of both patients (not having to wait until late in the day to have their procedure) and surgeons (who can go about their business without having their time wasted….surgeons value their time).
Hats off to a great idea that has resulted in efficiency improvements even in our competitors facilities in an attempt to try to keep up.
G. Keith Smith, M.D.
