before the scheduled start time. If surgery is scheduled to begin at
7:15 a.m., that's when the patient needs to be in the room. If a patient
is wheeled in just 1 minute later, we consider the case delayed.
However you measure an on-time start is fine, as long as everybody's
watches are set for the same time.
Document the reasons for late starts
Create delay codes to help categorize the reason for start-time
delays. Was the surgeon late arriving at the facility? Was the anesthe-
sia provider held up with another patient? Did the patient fail to show
up at the required time? Was the IV difficult to start? Were instru-
ments not ready? You want to gather accurate data and reduce the
amount of entries coded as "other," so consult with your frontline
staff to determine which codes would capture the issues they face in
getting cases started on time. Create a spreadsheet, dashboard or
some other communication tool so staff can quickly note the reason
for a delayed start. Track the delay codes over a couple months to
identify patterns of problem
areas. Update your team on the
results of the code tracking dur-
ing staff meetings, through e-
mail reminders or when you
walk the floor.
Fix what's broken
Make changes based on
the results of your findings.
When we determined that some
delays were the result of anes-
2
3
S E P T E M B E R 2 0 1 6 • O U T PA T I E N TS U R G E R Y. N E T • 3 1
What's your biggest barrier
to starting cases on time?
Tardy surgeons 85%
Incomplete paperwork 7%
Slow room turnovers 5%
Patients ignoring NPO orders 2%
Missing equipment or supplies 1%
SOURCE: Outpatient Surgery Magazine InstaPoll,
October 2013, n=477
InstaPoll
