Quality Improvement Initiative

Purpose of the Program

Turnover time in operating room (OR) is a critical infrastructure in the healthcare environment. The turnover time metric is free of patient-related variability and is thus used to measure healthcare personnel’s effectiveness in the OR. Turnover time is defined as the time taken by perioperative nurses to prepare a patient and operating room for surgery after the first patient’s successful wheeling out of the OR. The typical surgery activities include the surgeon closing the case, anesthetic completion, circulating nurse finishing documentation, and patient leaving the OR.

Reducing turnover time is an essential element in an organization’s success in safer and more surgeries (Rothstein and Raval, 2018). The reduction can be achieved through an automated medical record system. The electronic medical records are a game-changer as the circulatory nurses have all the necessary information in an OR; thus, it can best guarantee the safety of the patients by pointing out an anomaly in the patient by referring to prior procedures in the system. The automation can also be in the form of an electronic inventory system where the supplies needed for surgery are readily acquired, thus significantly reduce the time needed for the circulatory nurses to prep the OR. The inventory department is considered for automation to link up with OR systems since pre-operation procedures have a rippling effect on the OR turnover time duration. The purpose of this initiative is to reduce the turn over time between consecutive surgeries in the OR.

Target Audience

The target audience in the systems’ automation is the patients, circulatory nurses, and hospital staff in charge of inventory. The circulatory nurses are charged with the preparation of the OR before and after surgery. With the medical records’ automation, the circulatory nurse can send the list of the required equipment to the inventory teams electronically to prepare the tools immediately after the completion of surgery (Lee, Ding, and Guzzo, 2019). This is made possible by the preexisting electronic lists that detail the requirements for a specific operation. The automation of medical records targets the patient’s safety as all the preexisting conditions and procedures necessary are outlined; thus, the circulatory nurse has a better apprehension of the task and sufficiently advocates for the patient’s needs. The inventory system is up to date; hence any missing requirement is detected early and restocked to ensure seamless coordination between surgeries.

Benefits of the Initiative

There is improved documentation, which significantly increases the delivery of quality care. The medical records’ automation leads to the individualization of the patient’s needs in terms of information collected. The documentation of the patient’s records over time leads to better overall health information; thus, the circulating nurses can notice changes in the patient’s needs while under the influence of anesthesia. The reduction of turnover time leads to improved patient satisfaction levels. It reduces the wait time patients are subjected to in the preoperative area, ultimately alleviating the patient’s anxiety and stress levels.

Electronic medical records use leads to reduced medical errors while in the OR (Kumah-Crystal, Pirtle, Whyte, Goode, Anders, and Lehmann, 2018). The circulatory nurses have all the patient information, such as allergies and lethal medical interaction, thus making quick, informed decisions regarding patient safety. Seamless coordination with inventory staff leads to reduced turnover time, translating to more surgeries during work shifts. More surgeries improve the financial position of the hospital regarding reimbursements. An automated inventory system ensures appropriate supplies are ready to be wheeled into the OR as it is fed prior information regarding the type of surgery. This automation will significantly reduce the time the circulatory nurses are engaged with the supply teams, maximizing the time to sterilize the OR. This, in turn, will be instrumental in reducing the turnover time; thus, the organization will be in a better position to perform more surgeries while conforming to the standardized procedures. Automation also improves cost-effectiveness to the healthcare facility by suitably scheduling OR staff and reducing staff overtime pay. The staff is moved to adjust for fluctuations when an emergency arises. The reduction in overhead costs leads to economic viability with resources distributed appropriately.

Interprofessional Coordination

The coordinating teams required for the implementation of the initiative include all healthcare personnel in the hospital. The patient’s medical records are updated from admission to discharge of the patient; thus, the integration of information between departments is paramount. Interdisciplinary collaboration is essential in delivering comprehensive patient care through effective communication. The focus of automation is streamlining communication by implementing electronic data management systems. The electronic medical records for patients are initiated by admitting nurses, through to the physicians and clinicians, and later to circulating nurses. Each department continuously revises the records intending to furnish the OR team with accurate details. The inventory team collaborates with the OR team in terms of equipment discharge from the procurement department. The automated system checklists the available resources against the required items and their alternatives in case of an emergency, thus providing the OR team with appropriate tools immediately.

Cost of the Initiative

The project’s budget allocation is to implement a specialized program that will integrate the medical records into a single system. All health records are personalized from the patient admission; hence, with the already present computerized system, the project’s cost is relatively high as an integrated program and toolkit are required. The seamless flow of information requires the facility to host the servers. The cost of the perpetual license for the servers is huge, as it requires a significant amount of upfront fees. The inventory is linked with the circulatory nurse’s procedures and requirements regularly updated for easy accessibility of equipment. The interdisciplinary linking of information is through cloud computing, and accessibility is through an internet connection; therefore, subscription fees are added to the implementation cost (Zeadally and Bello, 2019). However, the program’s overall cost is significantly less than the cost associated with increased turnover time over a specified period.

Evaluation of the Project

The basis of the evaluation of the project will include; patient safety, patient satisfaction, punctuality of the surgeries, financial sustainability, and instrument preparation (Pedron, Winter, Oppel and Bialas, 2017). The automation of the medical systems will significantly contribute to reducing turnover time and an increase in patient safety coordinated by the circulating nurses. Patient safety and satisfaction metrics can be measured through the use of questionnaires to get their feedback. The feedback is subjected to a ratio scale with a maximum figure of ten to statistically gauge the results. The project’s success will also be viewed from the perceptive of punctuality of start times of surgeries as the instruments are prepared faster with the aid of the checklists provided by the nurses to the inventory teams. The patient advocacy by circulating nurses will be better placed to make informed decisions based on the patient’s updated records in case of an emergency where the patient is incapacitated. The financial assessment of the viability of the project is through insurance reimbursement amounts. Reduced turnover time increases the time surgeons spend in the operating room, translating to more funds to healthcare facilities to fund research.




Kumah-Crystal, Y. A., Pirtle, C. J., Whyte, H. M., Goode, E. S., Anders, S. H., & Lehmann, C. U. (2018). Electronic health record interactions through voice: a review: applied clinical informatics, 9(3), 541.

Lee, D. J., Ding, J., & Guzzo, T. J. (2019). Improving operating room efficiency. Current urology reports, 20(6), 28.

Pedron, S., Winter, V., Oppel, E. M., & Bialas, E. (2017). Operating room efficiency before and after the entrance in a benchmarking program for surgical process data—Journal of Medical Systems, 41(10), 151.

Rothstein, D. H., & Raval, M. V. (2018, April). Operating room efficiency. In Seminars in pediatric surgery (Vol. 27, No. 2, pp. 79-85). WB Saunders.

Zeadally, S., & Bello, O. (2019). Harnessing the power of the Internet of Things based connectivity to improve healthcare. Internet of Things, 100074.

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