1. Operating Room (O.R.) Schedule
1.1. Surgeries
1.1.1. Scheduled Surgeries
1.1.1.1. Patient
1.1.1.1.1. Late patients, lack of proper prep
1.1.1.1.2. Patient w/ Adverse Reaction or Co-morbidities
1.1.1.2. Surgeries do not go as planned/on schedule
1.1.1.2.1. Scheduling Conflict
1.1.1.2.2. Overbooked OR
1.1.1.3. Different Surgical Sub-Specialities
1.1.1.3.1. Neurosurgery
1.1.1.3.2. General Surgery/Vascular/Plastics
1.1.1.3.3. Orthopedics
1.1.1.3.4. Gynecology/Urology
1.1.2. Emergent Surgeries
1.1.2.1. Trauma Surgery
2. OR Delays
2.1. Equipment
2.1.1. Malfuncation
2.1.2. Availability
2.2. Staff Preparedness
2.2.1. Surgeon
2.2.2. Anesthesia
2.2.3. Nurse
2.3. Scheduling
2.3.1. Patients
2.4. Instrumentation
2.4.1. Quantity
2.4.2. Loaner Trays
2.4.2.1. Condition Received In
2.4.2.2. Time Received
2.4.3. Sterilization
2.4.3.1. Steam
2.4.3.2. Sterrad
2.4.3.3. Flash
2.5. Turn Around Time
3. High Throughput Process
3.1. Preoperative
3.1.1. Case Setup
3.1.1.1. Instruments
3.1.1.2. Supplies
3.1.1.3. Bed
3.1.1.4. OR Equipment
3.1.1.5. Anesthesia Cart
3.1.1.6. Medications
3.1.1.7. Initial Instrument counting
3.1.1.8. Initial Sponge/Supply counting
3.1.2. Patient Care
3.1.2.1. Identification
3.1.2.2. Preop clearance (EKG, LABS)
3.1.2.3. Correct Documentation
3.1.2.4. Informed Consents
3.1.2.5. Establish lines, medications
3.1.3. Staffing
3.1.3.1. Perioperative Nurse
3.1.3.1.1. Scrub Technician
3.1.3.2. Anesthesia
3.1.3.2.1. signed consents
3.1.3.3. Surgeon
3.1.3.3.1. signed consents
3.1.3.4. Miscellaneous
3.1.3.4.1. Medical Equipment Reps
3.1.3.4.2. Resident Physician
3.1.3.4.3. Fellow Physician
3.2. Intraoperative
3.2.1. Time Out - Establish correct patient, procedure/laterality, counts, medications, start time, introduce team members
3.2.2. Induce Anesthesia
3.2.3. Start procedure
3.2.4. Mid-procedure counts, documentation of any incidents, documentation of implants, laterality, equipment used.
3.2.5. confirm correct procedure, sterility, counts, and patient discharge plan
3.3. Postoperative
3.3.1. Transport to PACU
3.3.2. Give PACU report
3.3.3. Deliver pathology specimens for biopsy
3.4. Turnover
3.4.1. Cleaning Staff
3.4.1.1. Clean Operating Room
3.4.1.2. Establish Next Procedure Equipment / Supplies in Room
3.4.1.3. Establish Sterile Environment