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One month to faster patient turnover time

Quick Changeover in the OR

Long changeover (or turnover) times in the OR result in delayed treatment for patients, dissatisfaction for surgeons and staff, and large overtime bills for the hospital. No one wins. The Quick Changeover Program gets at the root of the problem. In one month, your patient turnover time will shorten dramatically, while your staff satisfaction skyrockets!

The Benefits of
Quick Changeover

Improved staff satisfaction with more predictable hours

Improved staff satisfaction with more predictable hours

Surgeons will stay in the department and cases will start on time

Surgeons will stay in the department and cases will start on time

Surgeons will be encouraged to bring more cases to the hospital

Surgeons will be encouraged to bring more cases to the hospital

Decreased overtime costs for the department

Decreased overtime costs for the department

Department runs more smoothly

Department runs more smoothly

Improved surgeon on-boarding

Improved surgeon on-boarding

Quick Changeover in the OR Program

How it Works:

Phases of the Quick Changeover Program

Assessment

We recommend starting with an assessment to see OR Room turnover as a part of a larger context. It would be counterproductive to engage in a whole OR Turnover improvement program to find out that is not the one issue that would have made the most significant impact for patients or clinicians.

Value Stream Mapping

This simple flowcharting method will enable the whole team to see the issues in the same light and to weight them by importance.

Develop T/O Improvement Program

There is a very strong chance that the Assessment will yield a large number of Opportunities for improvement above and beyond OR suite Turnover. All the opportunities will be documented and prioritized.

Plan for First Quick changeover Pilot

From the master list of improvement opportunities the assessment team will select the top 3-to-5 highest ranked opportunities and develop a mini-project plan for each one using the A3 Methodology. If OR Suite Turnover ranks within the top 5, then we will plan for the first pilot implementation.

Pilot Program

The first implementation should be considered a pilot program as many unknowns will be faced by the team. We have always reaped benefits from these pilot programs and we answered many questions, hence preparing the team better for future implementations.

Data Gathering: Work Steps

We will look at and document every work step every participant takes from the start of the OR Turnover to the end of it. For this step, we will use the Standard Work Definition forms that will be provided.

Data Gathering: Video

If possible, we will confirm the documented work steps using video recordings of the OR Turnover.

Data Gathering: Work Times

With a clean list of work steps, we will start documenting the time it takes to do the work. Each step will be timed independently. Time will be rounded to the next 0.1 minute.

Data Gathering: Supplies

For every step documented, we will ascertain the supplies required and the conditions for its use. Example: How should the floor cleaner be used? Can we step on it before it is dry? Is there a latency time?

Data Gathering: Players

For every "Actor" we will take an initial look at the work balance to see if there is a very substantial imbalance that must be addressed immediately or if there are any other players that should be invited to the program.

Data Gathering: Cleaning Methods

Cleaning methods are a crucial part of any Room Turnover project as they cannot be eliminated or performed outside the room. We will pay special attention to these steps as well as the supplies required.

Data Gathering: Reverse Logistics

We are hoping that by using a fancy term ("Reverse Logistics") to describe the removal of trash, we will make people take it as seriously as it deserves to be taken. We will spend some focused time in the documentation of all steps related to things going into the OR Suite, but also everything that must come out of it.

Quick Changeover Phase 1: Separate

This set of steps if focused on identifying and cataloguing each step as either "Internal" or "external". Internal steps of work must be done inside the OR Suite (wiping the floor) while external steps can be done outside the OR Suite. The goal is to choreograph every external step so there is not wait time caused by them.

Quick Changeover Phase 2: Convert

The team will focus on converting as many internal work steps into external work steps, hence reducing the length of the OR Turnover. Not all opportunities will be capitalized upon within the project, since some of them may require investment or time to make them happen.

Quick Changeover Phase 3: Streamline

Once all the internal work steps have been settled upon, the team's work will focus on making every step as efficient as possible by using the best possible practices, sequence, or supplies.

Document New Procedures

Each new procedure will be documented using Standard Work Definitions. If required, the hospital/system forms will be used and submitted for approval and turned into official documents.

Train Staff

The team will put together a training session to inform all staff of the new procedures, to explain the expectations, and to lay the ground for the next project(s)

Review Results and Plan for Next Target

A Final Report will be assembled by the team and it will be presented to the Management Team. This is done on the last day of the Pilot Project.

Frequently Asked Questions

What results should we expect?

A reduction of 20-30% in the total OR Suite Turnover is very common. Also more standardized, predictable, and better methods for the OR Suite Setup.


Can you guarantee the results?

In the same way you Doctor can guarantee that "Diet and Exercise" will make you loose weight. As long as you do what we agreed to do, you can take it to the bank.


Is this going to cause Clinicians to do more work?

No. It will help Clinicians take less time to a Room Turnover. If after the project there is more work for the Clinicians, we screwed up.

How many people need to participate in the Pilot Project?

Our preferred number is 6-to-8 plus 2 LGA Team members . We want a mix of Instrument Techs, Circulators, Nurse anesthetist, SPD staff, and OR Support Staff. Charge Nurses, Managers, Directors and other support departments will be asked to be on call to help.


How much classroom training should we expect?

For sure 2 hours of Value Stream Mapping and 4 hours of Quick Changeover. There my be some in-promptu sessions for Documenting Standard Work, 7S, or Cause and Effect Analysis among other topics.

Get Started Today!

Get Started Today!

Contact Gerard Leone, Principal of Lean Hospital Practice, to find out how we can assist your Lean Hospital Design efforts.

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