Date of Graduation

Fall 12-15-2017

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)


School of Nursing and Health Professions

First Advisor

Margaret Levine, DNP, RN, CNL, CNS



The purpose of this project is to improve efficiency by reducing turnover time in the operating room (OR) that can consequently enhance patients’ and physicians’ satisfaction, promote teamwork, and decrease the cost of operating room delays. The increasing trend of turnover time (TOT) requires attention for microsystem improvement in the OR of Santa Rosa Memorial Hospital. The intervention to improve efficiency is to educate the OR team members on roles and responsibilities to establish a standard workflow which can promote accountability and teamwork during the turnover process. Havelock’s theory of change is used as a framework for the action plan to cultivate synergy and team engagement. Fishbone diagram, process mapping, and strength, weakness, opportunities, threats (SWOT) analysis were used as quality improvement tools to identify causes of delays and to guide the improvement process. Based on the data collected from the pilot test using the plan, do, study, act (PDSA) cycle, the post-intervention average TOT was reduced to 29 minutes compared to 37 minutes at pre-intervention phase. There is a positive response from the pilot team on the standardized workflow as reflected by the post-intervention survey. The clinical nurse leader student as the team manager has influenced the implementation of this project by providing the support and leadership needed in engaging and promoting the change in the microsystem.

Keywords: improve efficiency, turnover time, operating room, teamwork, workflow, and clinical nurse leader.