Introduction: Delays are operating rooms can be attributable to system deficiencies. Routine delays in perioperative setting can not only negatively impact daily workflow, morale of the perioperative team and patient satisfaction but also increase costs in healthcare system. The study is to address the prevalence, causes and implications of the perioperative delays in Children’s Surgery Center at UC Davis Medical Center, specifically looking at delays in the first cases of the day and delays during the turnover process. By identifying the prevalence and causes of the delays, we aim to improve workflow, promote cost savings to healthcare system and increase patient satisfaction.
Methods: We performed a retrospective study on a total of 76 cases performed on a randomly assigned week (06/13/16 - 06/17/16) at Children’s Surgery Center. We analyzed the prevalence and causes of delays in starting first surgical cases of the day and delays in turnover process, which is defined as longer than 30 minutes from the finish of the last case.
Results: Delays for the first surgical cases were categorized into five major causes (surgery, anesthesia, patients, OR equipments, urgent cases). 66% of total first surgical cases were delayed. The most common cause (56% of delays) was related to surgical teams’ availability and surgical consent issues. Delays for turnover process were categorized into six major causes (surgery, anesthesia, patients, equipments, miscommunications, reasons undocumented). Turnover delays were commonly due to more than one factor; the two most common causes of turnover delays were related to surgical teams (34%) and miscommunication between perioperative teams (19%). A total of 1398 minutes were delayed for electively scheduled cases in one week period.
Discussion: Delays in the operating room are frequent and have a major effect on workflow, resource utilization and system efficiency. By identifying the prevalence and underlying causes of the delays, we can establish better communications between perioperative teams, provide better education to staff members and develop solutions to improve the workflow. Awareness of the frequency of delays, common causes and impacts of such delays hopefully would generate more conscious effort across perioperative teams to take appropriate steps to mitigate delays and hence, improve overall patients and parents’ satisfaction, workflow and cost savings to the healthcare system.
