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puts the onus on the surgeon to get into the OR when we call him. One of my surgeons was pushing for the 8 a.m. start to be incision time. The reason for that is he wanted to wait for the last minute to enter the OR suite."
The trouble with equating an on-time start with incision time is that incision time doesn't account for the many critical activities that take place — and take time — in the OR before and after the incision: the timeout, anesthesia time, positioning, prepping and draping, and then turnover time.
If your scheduled time for surgery is patient-in-room time, your surgeons should arrive 10 to 15 minutes before the scheduled time. "If the case is scheduled for 8 a.m., the surgeon should be in the room with the patient at 7:45, draped and ready to go at 8," says Karen Murphy, RN, MSN, director of the Northeast Regional Surgery Center in Plains, Pa.
Robert Lerma, MBA, CASC, chief operating officer of the Special Surgery Center of Houston (Texas), sets his patient-in-room clocks back an hour. "The patient is expected to be signed in and admitted into pre-op 1 hour before the scheduled time," he says. "If there is a block,
then we ask the patient to come in 11⁄2 hours before the scheduled time." OSM
