NARUS 2018: Tackling the Turnovers for Robotic Surgery

Las Vegas, NV (UroToday.com) Ms. Suzannah Sorin, a PA at New York University, discussed ways to improve turnover time for robotic surgery ORs. Ms. Sorin started by noting that the typical turnover time for a robotic OR may vary from <20 minutes to > 1 hour at various institutions. When first tackling turnover time at her institution, Ms. Sorin noted that turnover time was 50 minutes, broken down to: 10 minutes for previous case breakdown, 5 minutes to call for cleaning, 20 minutes for room cleaning, 10 minutes for next case set-up, and 5 minutes for next patient transport.

In order for NYU to improve on turnover time, it was important to change the paradigm and view tasks as a continuous and free-flowing form. To work on improving from a 50 minute to 30 minute turnover, Ms. Sorin highlighted that 25% of time should be reserved for previous case breakdown, 5% to call for cleaning, 40% for room cleaning, 25% for next case set-up, and 5% for next patient transport. In reality, these individual entities should be occurring simultaneously.

To further assess these individual time periods, Ms. Sorin provided further details:

Previous case breakdown: before the patient leaves the room, the instruments should be counted and sprayed, trash organized, bed repositioned, the patient transferred to the stretcher, and report given to PACU. Once the patient is out of the room, the carrier cart is removed and the bed is stripped. To improve on breakdown time, Ms. Sorin notes that the patient’s arms should be tucked to save time placing and removing arm boards, the bed bracket for stirrups only being removed on the side in which the patient is going to be transferred, and the stretcher should be readily available.
Call for cleaning: it is important to know when to make the call and how long it takes for cleaning services to arrive.
Room cleaning: it is important to know what tasks need to be done and what can be done to expedite the process. While the room is being cleaned, the staff can be prepping for the next cases by looking at the preference card, gathering extra supplies and locating any items on the case cart that may have been missed.
Next case set-up: it is important to know when is the appropriate time to open, what to open and what does the room need before the next patient can enter
Next patient transport: it is important to know when to call for the next patient and how far the preop holding area is from the actual OR

The key to changing the paradigm according to Ms. Sorin is the five P’s: parallel processing, planning, practice, productivity, and partisanship.

Presented By: Suzannah Sorin, New York University, New York, NY

Written By: Zachary Klaassen, MD, Urologic Oncology Fellow, University of Toronto, Princess Margaret Cancer Centre, @zklaassen_md ,at the 2018 North American Robotic Urology Symposium, February 16-17, 2018 - Las Vegas, NV

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