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SIP 3

SIP 3. Day of Surgery: After first incision until midnight. Process Flow. 1 st Patient. OR. PACU. Discharge/ Floor. 2 nd Patient. Floor/ Check-In. Pre-Op. OR. PACU. Discharge/ Floor. 3 rd Patient. Floor/ Check-In. Pre-Op. OR. PACU. Discharge/ Floor. Call for next patient.

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SIP 3

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  1. SIP 3 Day of Surgery: After first incision until midnight

  2. Process Flow 1st Patient OR PACU Discharge/ Floor 2nd Patient Floor/ Check-In Pre-Op OR PACU Discharge/ Floor 3rd Patient Floor/ Check-In Pre-Op OR PACU Discharge/ Floor

  3. Call for next patient Close Patient 1: Pt Out OR Pt ready to go to OR Patient 2: Pt In OR IP PAV Data • An overlap of activities occurs between the current case and the following case, playing a vital role into the continuum of the OR day

  4. Data • Average turnover time and prep time vary according to site: • Main: 71 min • Main Annex: 63 min • Pavilion: 48 min • Roosevelt: 34 min

  5. Issues • Hand-offs of patients and between staff make transitions difficult • The process is not visible and staff do not know if and when critical activities have occurred • Information sharing via paper or verbal does not happen in a timely manner • Changes in plans are not communicated to everyone • Paging or contacting the appropriate staff/faculty is time consuming and difficult • A balance must be made between surgery and education

  6. Analysis • Communication plays a major role in all aspects of the process • By reducing the turnover time and prep time, it will allow for maximum amount of OR utilization for patient safety

  7. Key Areas of Focus • Communication at Hand-Off • “Briefing” • Turnovers • TBA and Emergent/Urgent Case Management

  8. Obstacles • Culture – Everyone must work together as a team to meet a common goal • Culture – Each individual does not need to be efficient as long as the entire system is effective • Political – Each “group” has their own agenda

  9. Current Activities • 5S Events • Equipments (x2) • Turnover Prep • RPI’s - Turnover • Team Projects • Standardized Report at Hand-off • Briefing of the rest of the day

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