185 - Enhancing Operating Room Efficiency with the New Optimization Nurse Role

Description: Description of team
This initiative is led by a multidisciplinary team that includes the Director of Nursing, Operating Room Nurse Managers, a Perioperative Educator, Operating Room Nurses. This collaborative team is dedicated to improving OR efficiency, enhancing communication, and optimizing patient flow across the surgical continuum.
Preparation and planning
A comprehensive review of operating room (OR) efficiency metrics in preparation for this initiative revealed ongoing challenges with first case on-time starts (FCOTS), inconsistent turnover (TO) times, and workflow delays impacting overall throughput. Feedback from frontline OR nurses highlighted a critical gap in support particularly a lack of dedicated resources to help them meet evolving quality and performance expectations. Recognizing the need for targeted intervention, the planning phase focused on identifying a role that could directly address these gaps, facilitate smoother transitions between cases, and serve as a liaison between clinical staff and leadership to drive real-time problem-solving and quality improvement.
Assessment
In response to ongoing operational challenges and staff feedback, the OR Leadership Team conducted a thorough assessment of existing workflows and barriers to efficiency. It became evident that clinical nurses with full patient assignments were unable to consistently manage additional tasks critical to ensuring on-time starts and smooth case progression. To address this gap, leadership strategically explored a dedicated role with no direct patient care assignment, focused solely on facilitating throughput and supporting operational flow. This role was designed to provide real-time, hands-on support to the surgical team while serving as a vital connector between frontline staff and leadership to raise awareness of systemic issues impacting efficiency.
Implementation
This initiative evaluated the impact of dedicated "Optimization Nurses" (OP nurses) on FCOTS and TO times in the OR. In May 2024, three volunteer nurses were selected for this role. After a two-month trial, the two nurses demonstrating the most significant improvements in FCOTS and TO were retained as OP nurses. The implementation of a structured checklist for the OP nurse correlated with improvements in FCOTS and TO efficiency.
Outcome
With the use of a new role, we have sustained our FCOTS performing above the benchmark of 80% and decreased our TO to meet and exceed the benchmark. TO times exceeded 40 minutes in 5 of 8 months prior to launching the rounding initiative, underscoring the need for process improvement. Therefore, the implementation of this role has proven to be instrumental in the throughput of Perioperative Services and. hospital.

Implications for perioperative nursing
The integration of an OP Nurse into perioperative care has significant implications for nursing practice. This specialized role streamlines patient preparation, ensuring that individuals are in the best possible condition before surgery.
This proactive approach enhances patient safety and improves surgical outcomes. OP Nurses play a critical role in preparing patients for surgery on the day of the procedure. Limitations of the study include a small number of operating rooms, which may present challenges with scalability to a larger number of rooms, and the manual aspect of data collection, which could affect efficiency and consistency