Perioperative Efficiency Tool Kit now available

The Perioperative Efficiency Tool Kit became available to AORN members in July 2013. “Perioperative efficiency” involves the

use of effective patient- and team-focused strategies to optimize operational efficiency in the perioperative setting, which includes safely preparing patients for surgery, minimizing room turnover time, and starting surgical procedures on time. The tool kit is designed to capitalize on opportunities for improving patient safety and coordination of care, minimizing delays and waste, and enhancing the perioperative experiencefor patients, family members, and perioperative team members. The tool kit consists of a variety of customizable tools and resources, including a slide show, process improvement roadmaps for first case of the day on-time starts and room turnovers, definitions of team members’ roles and responsibilities, policy templates and examples, pre-admission testing guidelines, preoperative checklists, and patient educational materials. Afterreviewing the components of the tool kit and completing an online evaluation, members can receive 1.5 continuing education contact hours.

Leslie KnudsonManaging Editor

Task force workThe Perioperative Efficiency Task Force was

charged with developing a tool kit that would provide AORN members resources to optimize perioperative patient flow and operational efficiency. Between March 2011 and March 2013, the task force developed a variety of tools and resources for the tool kit and conducted a membership survey to determine common practices related to preoperative testing. Elena Canacari, RN, CNOR, associate chief nurse of perioperative services at Beth Israel Deaconess Medical Center, Boston, served as the chair of the Perioperative Efficiency Task Force. “I think perioperative efficiency is an opportunity to improve the care of our patients and create predictability in our work environment,” said Canacari. “It’s that balance between production pressure and operational efficiency while bringingpatients through the process in a safe manner.”

As part of the development of the tool kit, the task force defined two cycles of events that occur

http://dx.doi.org/10.1016/S0001-2092(13)00738-2© AORN, Inc, 2013

concurrently in the perioperative setting: the “patient cycle” and the “OR cycle.” Members of the task force examined the complete patient cycle, including scheduling of surgery, obtaining preoperative patient information, preoperative showering, following preoperative checklists, and educating patients and family members. The task force also examined the OR cycle and the processes necessary for efficient room turnover.

As part of the examination of the two cycles, the task force identified roadblocks to efficiency, such as lack of physician orders, patients needing translation, lack of or missing patient consents, and missing test results. The task force also identified factors that cause delays for the first cases of the day to start on time and for room turnovers. Delays in first case starts and room turnover were attributed to manpower (e.g., late or unavailable providers), documentation (e.g., signed consent not available), communication (e.g., lack of patient/family education), methods (e.g., invasive lines, blocks), environment (e.g., room unavailable in preoperative area), materials (e.g., instruments not available/nonsterile), patient (e.g., late arrival), and equipment (e.g., equipment not available).

The complete work of the task force emphasized the need for improved teamwork and communication and helped to identify the many opportunities that exist to improve patient preparation, perioperative processes and workflow, and quality and safety processes. “Communication and teamwork cannot be stressed enough for streamlining and standardizing processes that will serve to increase efficiencies and improve patient, physician, and staff satisfaction,” said Patricia A. Mews, MHA, RN, CNOR, member of the task force and consultant at Mews Surgical Consulting, LLC., Scottsdale, Ariz. “We should strive to enhance the perioperative experience for the patient and family as well as the perioperative team members.”

Access the tool kitAORN members can access the Perioperative

Efficiency Tool Kit at http://www.aorn.org/Clinical_Practice/ToolKits/Tool_Kits.aspx.

August 2013 Vol 98 No 2 • AORN Connections | C7