Date of Graduation

Summer 12-13-2024

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

Program

Kaiser cohort MSN capstone

First Advisor

Catherine Coleman, DNP, RN, PHN, CPHQ, CNL

Second Advisor

Carla Martin, DNP, RN, CIC, CNL, NEA-BC, FACHE

Abstract

Abstract

Problem: A local Bay Area hospital Ambulatory Surgery Unit (ASU) strives to maintain the first case on-time starts (FCOTS) at 90%. Optimal FCOTS compliance enhances operating room (OR) efficiency, resource utilization, and patient outcomes. Data from January 2022 to December 2023 shows that ASU’s FCOTS remains at a monthly average rate of 67%. This project focuses on closing the 23% gap by achieving 73% FCOTS compliance in the first quarter to progressively achieve the unit 90% goal or higher.

Context: The five ASU ORs handle a daily volume of 25-35 cases. An interdisciplinary team conducted a root cause analysis to determine the causes of delays and explore potential solutions to promote punctuality.

Interventions: The main barriers identified were effective communication, interprofessional accountability, and unclear shift workflow. These findings drove the implementation of daily morning and afternoon huddles to streamline communication, identify interdisciplinary champions to co-lead this project and revisit the staff roles and responsibilities within the process.

Measures: Success was measured by the percentage of surgeries starting at 0745. Delays in minutes were calculated, and the causes of delay were documented.

Results: FCOTS gradually increased from 67% to 73% over four months, reducing delays by an average of 11.3 to 9 minutes each month.

Conclusions: Effective team communication, streamlined workflows, clearly defined staff roles and responsibilities, and behavioral accountability effectively achieve operational efficiency in the OR. These interventions foster a culture of safety, process ownership, and interprofessional teamwork.

Keywords: operating room, delays, first case on-time start (FCOTS), improvement, efficiency

Download

Included in

Nursing Commons

Share

COinS