193 - Setting the Stage for Success: OR Setup and On Time First Cases

Description: New York Presbyterian Allen Och Spine Hospital is a 196-bed community hospital serving northern Manhattan and the Bronx. It contains 6 Operating Rooms, specializing in spine surgery and is staffed with over 65 employees. An average of 560 spine surgeries is performed per year. These spine surgeries include simple one level decompressions, complex multilevel deformities with instrumentation and fusions, and tumor removals. Both Neurology and Orthopedic perform surgical procedures requiring specialized equipment, supplies and instruments tailored to individual surgeon preferences. These differing needs add complexity to case preparation. In addition, bed set up varies for each patient based on the spinal levels being operated on and the required positioning. Each patient and surgical patient is unique, which can make strict standardization difficult.
A first case on-time start (FCOTS) is a meaningful indicator of team efficiency and resource coordination in the OR. After observation and collection of data, OR leadership saw opportunities to improve the first case starts. OR preparation accounted for the most substantial delay in workflow. A dedicated committee was established to enhance performance, with the goal of increasing FCOTS from 80% to 90%, measured on a monthly basis. Included in this committee were RNs, CSTs, PPCAs and CSPD personnel. After implementing several strategies, an improvement was seen for 3 consecutive months with a high of 88.8%.