OR of the Year
Announcing the winners of the first annual OR of the Year Awards.
August 22, 2011
In the first annual OR of the Year Awards, Surgical Products sought to recognize operating rooms across the country that are advancing and improving surgical care. We looked to identify ORs that are making an impact in the surgical community, and recognize their efforts in moving surgery forward. Considering the many areas of achievement for today's ORs, such as new construction, infection control, procedural efficiency, new technology, procedural advancement and environmental efforts, we simply could not pick one just OR amongst the impressive list of nominees. With that, Surgical Products announces several winners in various categories, each OR achieving their own unique accomplishments, and all deserving recognition as an OR of the Year.
St. Luke’s Regional Medical Center, Sioux City, IA
Types of cases performed: Orthopedic, GYN, General, Neuro, ENT, Spine, CV, Chest, Plastic
OR utilization: 90 percent, 0700-1530 Monday - Friday and after hours for emergency cases
On March 2, 2010, St. Luke’s Medical Center opened a brand new operating room. Recognizing how powerful of a recruitment tool new facilities and technologies can be in attracting and retaining high quality physicians, the center embarked on the new OR project, completing construction in phases over a three-year time span.
The new OR at St. Luke's features six large rooms with state-of-the-art equipment. Each room features three flat-panel screens, enabling surgeons to view laparoscopic procedures from any angle. A PACS system in each room also allows staff to view any X-ray, CT scan or MRI in the OR electronically, and images can be placed on flat panel screens for surgeons to view while operating. The facility also purchased all new Neptune suctions [Stryker] for each OR, making the job of the staff easier and safer.
The new surgical area is also designed to enhance patient flow and privacy. The unit was built in an oval-shaped layout, so equipment and supplies are conveniently and readily available. This has been a time-saver for staff and a factor in St. Luke’s achievement of lower infection rates. Currently, the facility boasts an infection rate well below the national average, and continues to work hard to keep it that way. The square footage of each OR was increased from approximately 500 square feet to nearly 650 square feet, also helping to alleviate safety issues.
In addition, the project included the construction of new, private pre-operative and post-operative patient rooms and a patient waiting area. The hospital’s decontamination and sterile processing center was relocated from the lower level to the first floor, again adding to more efficient work flow. At the start of the project, the hospital’s patient and admitting entrance was relocated to the visitor’s entrance, creating one main centralized hospital location.
Since the renovation, the facility says the new surgical services area has created a unique physician relationship tool for St. Luke’s, and it has experienced an increase in new physicians scheduling their patients at the facility, due to the new state-of-the-art ORs.
“Since opening our new OR, we have surgeons from other facilities requesting block times here,” says Dorey Meyer, RN, BSN, Assistant Nurse Manager.
“Our staff takes pride in our facility and works very close and hard with the surgeons to provide the best care.”
Surgeons at St. Luke’s have also begun performing new procedures, including laparoscopic total hysterectomies and hip arthroscopies, bringing even more new equipment to the facility for these procedures. Furthermore, the St. Luke’s OR team takes pride in the fact that they are helping the environment through recycling. Currently, the OR recycles blue sterilization wrap, plastic and batteries, and continues to look for other items they can recycle.
Queens Medical Center, Honolulu, HI
Types of cases performed: Orthopedic, Trauma, TCV, Neuro, ENT, Plastic, General, GU, Robotic, Endovascular
OR utilization: 80 percent
Since the end of 2004, Queens Medical Center has worked to develop one of the fastest growing robotic surgery programs in the country. The facility purchased their first surgical robot in December 2006, and in 2008 purchased a second robot. To date, the program has performed over 2,000 robotic surgeries and continues to increase its work load. In 2007, the facility performed 242 robotic surgeries, while 837 cases were performed robotically in 2010. Furthermore, when the robotic program started at Queens Medical Center, 47 percent of prostate cases were performed robotically. In 2010, 94 percent were done robotically.
“The robots have really created a huge increase in work load,” says Joy Shapiro, RN and OR manager at Queens Medical Center. “It has brought surgeons to the hospital. Surgeons who weren’t coming here started coming here and bringing other cases with them. We are even dreaming about a third robot. Technology is the future.”
Shapiro says Queens Medical Center is the only facility in Hawaii with a robotic program, aside from the military hospital, which acquired a robot a little over a year ago. She says while there is definitely a cost associated with robotics, the benefits the facility has seen have outweighed the costs.
“The two robots are always in use,” Shapiro says. “And, it’s better for the patients. All the things that the research has found about the benefits of robotic surgery – we’ve experienced.”
The facility recently renovated two OR suites to become state-of-the-art MIS rooms in addition to its two MIS/robotic rooms. Queens Medical Center also boasts:
- A flourishing new graduate RN program that has resulted in 15 new nursing graduates working in the facility’s OR over the past three years.
- A decreased turnover rate of less than 5 percent.
- Currently zero open RN or tech positions at the facility.
Texas Orthopedic Hospital, Houston, TX
Types of cases performed: Orthopedic
OR utilization: about 65 hours per week
Opened in 1995, Texas Orthopedic Hospital is a 49-bed orthopedic specialty hospital with 17 operating suites. The facility has 30 dedicated orthopedic surgeons, each with an orthopedic sub-specialty. For three years in a row, the facility has been recognized for its commitment to orthopedic surgical excellence, with inclusion in the U.S. News and World Report list of the top 50 orthopedic surgical hospitals in the nation. In 2010, Texas Orthopedic Hospital ranked #23 in the nation and is the highest ranked hospital in Texas.
The facility prides itself in having several medical school academic affiliation agreements, as well as its role in serving as a teaching hospital for residents and fellows every year. Additionally, its operating rooms serve as the training facility for orthopedic technicians through affiliation agreements with Houston Community College and Galveston Community College. This year, central sterile processing technicians will also join the ranks of students taught in the operating suites at Texas Orthopedic Hospital.
The OR staff at Texas Orthopedic Hospital actively participates in the Centers for Medicare & Medicaid Services (CMS) reported Surgical Care Improvement Project (SCIP) measures. The facility has achieved 100 percent of the SCIP measures for which the OR staff is directly responsible. In 2010, OR staff achieved a surgical site infection rate of less than 0.5 percent in over 9,223 cases performed. This year, the mandatory reporting of surgical site infections to the National Healthcare Safety Network (NHSN) continues to demonstrate Texas Orthopedic Hospital’s low rate of surgical-site infections with all reported orthopedic procedures below national pooled mean rates.
Through these dedicated efforts, the OR staff of Texas Orthopedic Hospital continues to provide the highest level of care to each and every patient that comes through the organization.
OR Efficiency, Large Hospital
Fairview Southdale Hospital, Edina, MN
Types of cases performed: General, CV, Bariatrics, Robotics, Ortho, Urology, OB/GYN, Dental, Plastics
OR utilization: 24 hours per day, 7 days per week
Over the past two years, the main operating theatre at Fairview Southdale Hospital, which includes 17 rooms, has made strides to improve procedural efficiency by reducing turnover times and increasing on-time starts. The facility’s data shows significant improvement from 2009 to 2011, with a 20 percent gain in efficiency. Baseline in 2009 was 40 percent for on-time starts for all cases of the day. Today, data shows 62 percent on-time starts. This increase was also noted in the first case of the day on-time starts with a 24 percent gain, moving the first case on-time starts from 56 percent to 80 percent.
“This increase in efficiency has improved surgeon satisfaction by allowing cases to be started on-time and add-on cases to be worked into the schedule,” Kurt Johnson, BA, RN says. “This also provides a better patient and family experience by reducing the anxiety of those awaiting a surgical procedure.”
OR Efficiency, Small Hospital
CHRISTUS Santa Rosa Medical Center Hospital, San Antonio, TX
Types of cases performed: Inpatient/Outpatient, with highest volume in Total Joint Replacement, Robotics-Urology, Minimally Invasive CV, CV Transplant and Ventricular Assist Device, General Surgery, Large Thoracic Procedures, VATS, Esophagogastrectomy, Advanced Laparoscopy
OR utilization: 12 hours per day, nights and weekends are on-call
CHRISTUS Santa Rosa Medical Center is a small hospital of 178 beds doing big things. The facility’s surgical department consists of five operating room suites performing some of the most technologically-advanced procedures.
Recently, the OR was given a goal to reduce case turnaround time from 27 minutes in its 2010 fiscal year (which began July 2009) to less than 20 minutes by the fiscal year 2011. This goal was daunting, given the procedure mix performed at the facility. According to LaNell Scott, RN, CNOR, Director of the PeriOperative Department at CHRISTUS Santa Rosa Medical Center, the cases performed at the facility are large cases and require very detailed, highly-resourced set-ups.
Despite these challenges, the OR team not only achieved the goal but exceeded it. The last month of the 2010 fiscal year resulted a turnover time of 17 minutes. Scott explains achieving this goal required “absolute awareness” and team work from all staff members.
“We let everybody know what we wanted to do,” she says. “We discussed with the team how best to achieve it and then set that goal.”
To reduce room turnover time, the team started by identifying key areas for improvement, such as standardized cleaning processes. They also began a process they call “parallel turnaround,” meaning while staff members are still in the room finishing one case, there are multiple tasks they can perform in preparation for the case to follow.
“Identifying some of those areas was very beneficial for us,” Scott says. “It gets you ahead the curve when you’re turning rooms over. Since we have basically one shift – everything after hours is on call – our team is motivated to work as efficiently and as effectively as we possibly can.”
Scott says the staff’s work to achieve a greater OR efficiency has been fun and exciting, and has even created some friendly peer competition among staff members in getting rooms turned around. In fact, the department has achieved outstanding associate satisfaction scores for two consecutive years, as measured by Press Ganey.
The OR staff has received recognition from hospital administration as well as surgeons that utilize the facility, impressed with the OR efficiency. The department also reports greater than 100 percent productivity and has met all its financial goals.
“The teamwork exhibited by this highly-functional team is overwhelming,” Scott says. “Our team is a very engaged group of hard-working associates that take true ownership in our department. It shows in the care we are able to provide and the services we are able to provide to our surgeons.”