Date of Graduation

Summer 8-6-2025

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

Liesel Buchner

Second Advisor

Sara Horton-Deutsch

Abstract

Problem: Limited operating room (OR) availability is a significant challenge in many healthcare facilities. Overbooked or understaffed ORs can lead to delays in surgical procedures, which are particularly detrimental in urgent and emergency situations (Cholewa et al., 2024). The OR is among the costliest areas in a hospital; it is essential to improve efficiency in surgical throughput to deliver timely care for urgent and emergent cases, enhance patient outcomes, and manage healthcare costs effectively.

Context: The microsystem for this project is a Northern California OR that handles a high volume of surgical procedures. There is a dedicated red room for urgent and emergent cases, with a target turnover time (TOT) of 45 minutes.

Intervention: Three Plan, Do, Study, Act cycles were introduced, focusing on streamlining communication using alpha text,environmental services (EVS) to use OR tape barrier during room turnover, and daily huddles between OR, post-anesthesia care unit, and supply chain at 9:00 a.m. and 4:00 p.m. to review the day’s schedule and to address potential issues that could cause delays.

Measures: TOT is defined as the interval from one patient exiting the OR to the next patient entering, with a target of 57 minutes; any arrival after this time is recorded as a delay. The causes and durations of these delays are monitored using Health Connect. Process measures include the use of OR tape barriers by EVS during room turnover, alpha text messaging to facilitate communication with surgeons and anesthesia, and daily huddles involving the OR, PACU, and supply chain teams.

Results: Data were collected from January 2025 to June 2025. In January, the baseline average of TOT was 71 minutes. After implementing interventions, we observed rapid improvement in February, an average of 63 minutes. In March, there was a continuous improvement to 57 minutes. April saw an increase to 63 minutes, but there was a rapid decrease to 49 minutes in May, and by June we are sustaining the improvement with an average TOT of 52 minutes.

Conclusions: In conclusion, we decreased the TOT in the red room from 65 minutes to 57 minutes over 5 months. Although there were increases in TOT in February and April, it has recovered in the last 2 months, and the progress is significant.

Download

Share

COinS