Problem Statement: For OR start times, how does adding OR nurse assignments to an EPIC Snapboard shared calendar for daily morning assignments compared to a paper copy of the nurse assignment sheet, affect the number of minutes the first 10 OR case start times are delayed within a 7 week time frame?
Background: On-time OR first case start times are important in maintaining daily on-time surgeries throughout the day. Increasing communication among OR and perioperative nurses may help to improve first-case OR on-time starts.
Approach: Individualized training was provided to the OR charge nurse designee on how to use the EPIC Snapboard Shared Calendar feature by inputting the names of the OR nurses assigned to patients the morning of the assignments. Data were collected using an OR On-Time Start Tracker that was developed as a way of recording the key elements involved in measuring pre-operative processes. These items included: date, patient ID, scheduled start time, AOD time ready, surgeon arrival time, time H&P completed, anesthesia ready time, OR nurse ready time, and time out of the AOD to surgery (recorded as on time, delayed in minutes, or early in minutes). If delayed, the reason for the delay was recorded in the tracker for each case.
Results: On-time first case starts increased by 30%, delays in first case starts decreased 23% , and test delays such as pre-operative x-rays (KUB) decreased by 7%. Average number of minutes for on-time first case starts increased by a difference of 1.03 minutes as compared to the average number of minutes for first case start delays which decreased by 15.02 minutes. Average number of minutes healthcare professionals had completed their pre-operative procedures prior to rolling out of AOD for first case starts increased by 4.33 minutes (OR nurses), increased by 12.55 minutes (Anesthesiologists), increased by 7.88 minutes (Surgeons), and increased by 4.9 minutes (AOD nurses). First-case start time delays were highest for surgeon delays (66%), test delays(14%), patient late arrivals (13%), H&P completion, (7%).
Discussion/Implication to practice: SnapBoard in EPIC is a helpful communication tool in the operating room to enhance communication between perioperative and operative nurses.
See more of: Invited Posters