- CA S.
- Z K.
- BJ M.
- MC I.
- G P.
Defining On-Time Start
Surgeon On-Time Consents and Site Marking
On-Time Consents and Perioperative Team Sign-In
Synthesis of Literature Findings
Goal and Objectives
|FIRST Case Start Times in the OR Weekly Report|
|Dates||OR 1||OR 2||OR 3||OR 4||OR 5||OR 6|
|Project Improvement: “Improve On-Time First Case Starts in the Perioperative Setting” Data Collection Sheet (Please fill out for first case of the day)|
|Scheduled surgery date & time ______|
|Patient arrival time in preop holding ______|
|Surgeon arrival time to preop holding ______|
|Patient identification ______|
|Procedure and procedure site identified ______|
|Site marked ______|
|Consent(s) signed ______|
Financial Analysis and Budget
FedsDataCenter.com: Data from uncle sam.
|1. Labor Costs|
|Title||Project Role and Duration||Average Annual Salary||Average Hourly Rate||Hours Projected||Rate X Hours|
|Nurse Educator||2 education session (I hr per)||$ 63,000.00||$ 30.30||2||$ 60.60|
|Charge Nurse||Data collection (3 months)||$ 80,000.00||$ 38.50||60||$ 2,310.00|
|Surgical Nurse Administrator||E-mail notification (1 month)||$ 70,000.00||$ 33.65||20||$ 673.00|
|CRNA||Project leader (3 months)||$ 169,000.00||$ 81.25||120||$ 9,750.00|
|2. Supply costs|
|Type||Purpose||Cost||Cost per unit||Units projected||Cost X units projected|
|Paper||Data collection sheet and visual aid||$ 14.89||0.03||407||$ 12.21|
|Ink||Data collection sheet and visual aid||$ 84.99||0.04||407||$ 16.28|
Project Evaluation Plan
ASQ: excellence through quality.
Conclusions and Recommendations
- Data For Benchmarking Your OR's Performance. 1st ed.(OR Manager; 2012. Available at:)https://www.ormanager.com/wp-content/uploads/2012/01/0112_ORM_5.Benchmark_r.pdfDate accessed: June 1, 2020
- First-case operating room delays: Patterns across urban hospitals of a single health care system.J Patient Cent Res Rev. 2016; 3: 125-135
- Simple solutions for reducing first-procedure delays.AORN J. 2011; 93: 450-454
- Surgeries in Hospital-Based Ambulatory Surgery and Hospital Inpatient Settings.2014 (Statistical Brief #223. PubMed. Available at:)Published 2020. Accessed June 1, 2020)
- Improving operating room efficiency: First case on-time start project.J Healthc Qual. 2017; 39: 70-78
- Crossing the global quality chasm: Improving health care worldwide. The National Academies Press, Washington, DC2018: 2-4
- The true relevance of first-case start delays.Am J Surg. 2015; 209: 427-429
- Practical Guide to Surgical Data Sets: Veterans Affairs Surgical Quality Improvement Program (VASQIP).JAMA Surg. 2018; 153: 768
- Johns Hopkins Nursing Evidence-Based Practice.SIGMA Theta Tau International, Center for Nursing Press, 2012: 77-85
- (2016). Preventing delays in first-case starts on the neurosurgery service: A resident-led initiative at an academic institution.J Surg Edu. 2016; 73: 291-295
- Innovative Solutions.Dimensions Crit Care Nurs. 2011; 30: 256-262
- Process redesign to improve first case surgical starts in an academic institution.J Invest Surg. 2014; 28: 95-102
- Automated reminders and physician notification to promote immunosuppression adherence among kidney transplant recipients: A randomized trial.Am J Kidney Dis. 2017; 69: 400-409
- Weekly e-mail reminders influence emergency physician behavior: A case study using the joint commission and centers for Medicare and Medicaid services pneumonia guidelines.Acad Emerg Med. 2009; 16: 626-631
- Prospective memory in the ICU: The effect of visual cues on task execution in a representative simulation.Ergonomics. 2013; 56: 579-589
- Reminders through association.Psychol Sci. 2016; 27: 973-986
- A randomized trial of SMART goal enhanced debriefing after simulation to promote educational actions.West J Emerg Med. 2018; 19: 112-120
- J. Innovations in knowledge transfer and continuity of care.Can J Nurs Res. 2004; 36: 89-103
- Translation of Evidence into Nursing and Health Care Practice by Kathleen M. White and Sharon Dudley-Brown.J Hosp Librarianship. 2014; 14: 101-102
- Successful interventions to reduce first-case tardiness in Dutch university medical centers: Results of a nationwide operating room benchmark study.Am J Surg. 2014; 207: 949-959
- A quality improvement project to improve first case on-time starts in the pediatric operating room.Pediatr Qual Saf J. 2020; 5: e305
- FedsDataCenter.com: Data from uncle sam.(Available at:)https://www.fedsdatacenter.com/federal-pay-rates/index.php?y=2018&n=sales%2Cedward&l=WEST+PALM+BEACH&a=&o=(Published 2020. Accessed June 1, 2020)
- Office Depot Office Max.(Available at:)Published 2020. Accessed March 8, 2020)
- ASQ: excellence through quality.(Available at:)
- Statistics for Evidence-Based Practice in Nursing.2nd ed. Jones & Bartlett Learning, Burlington, MA2017: 40-52
Conflict of interest: None to report.