Avoiding Delays for Surgery: It is Important

Sunday, 8 November 2015: 11:40 AM

Susana Dominguez, BSN, ADN, RN
Surgical Center, Midland Memorial Hosptial, Midland, TX, USA
Arculana Robles, RN, BSN
Surgical Center, Midland Memorial Hospital, Midland, TX, USA

Problem: No physician pre-operative orders and day of surgery orders was identified as a critical challenge. Absent physician orders was causing delays in surgical start times due to lack of operative consent and incorrect or missing pre-operative testing needed by the physician.

Aim:  The aim for the CIT project was to find a solution to prevent patients from arriving to their pre-operative appointment without any orders. One physician showed interest in participating in the project to prevent delays in his surgery start times. A group of nurses from the pre-operative center and same day surgery met with physician to find a solution to the problem.  During this meeting, the data collected was presented to the doctor.

Method: Data was collected to determine how many patients from his office presented to pre-op without orders and still went to surgery. The physician then passed the collection of data back to his staff. The solution was that all patients would have orders inputted in the electronic medical record at the time of their appointment with the physician. It was also decided by the physician that all patients would be seen one day prior to their pre-operative appointment to aid in this process.

Results: Data was collected after the implementation of the new guidelines. A dramatic decrease in patients arriving with no orders was noticed. The physician saw a total of 26 patients during the data collection period and 6 patients, or 24%, arrived with no pre-operative orders. After the solution was implemented, only 1 patient out of 18, or 6%, arrived with no per-operative orders resulting in a positive test of change.

Conclusion/Recommendation: Since the process worked well with this physician, the process is being implemented with other offices to hopefully yield the same positive results.  


Fennel, V. M. (2013, June 6). DNV Issues Top 15 Challenging Standards - Hospital Accreditation & Compliance Journal. Retrieved from http://www.compass-clinical.com/hospital-accreditation/2013/06/19/dnv-issues-top-15-challenging-standards/