process. You can create a task list that identifies each team member's
role during case breakdown and setup. You'll be able to see if you
need more (or fewer) staff involved and where. If too many people
are cleaning the room at once and no one knows their particular
tasks, some surfaces will be cleaned more than once and some sur-
faces not at all. Who is assigned to remove unnecessary equipment
and bring in needed equipment and connect it for the next case? Can
this be someone other than the scrub tech or the circulating nurse?
3. Map out the turnover process. This next step requires a bit of
choreography. Make a list of everything that needs to be accom-
plished and place it side by side to each team member's assigned
tasks. Visualize which activities can safely be conducted simultane-
ously. You may see areas where one team member may be of assis-
tance to another to close a gap and save some valuable time. Look at
how the work of several individuals may dovetail. Nothing feels quite
so good as when a plan comes together.
4. Communicate, communicate, communicate! Everyone
needs to take responsibility for strong and clear communication. If a
case is completing early, the circulating nurse needs to be responsi-
ble for communicating with the next case's stakeholders via the
front desk. That way, she can notify everyone involved in the next
case so that they can turnover the room immediately upon comple-
tion of the case. Meanwhile, the next patient can be readied and the
case can proceed smoothly. Or you can provide walkie-talkies to the
cleanup crew. This way, they can better communicate among them-
selves, increasing their efficiency and better aligning their resources
for room turnover. Note: If the surgeon is going to leave the OR
between cases, be sure you know how to contact him.
6 0 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J U N E 2 0 1 8
