OR Staffing - MD only

[militarymd]

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Anyone out there in an all MD practice where your hospital is giving 2 rooms to surgeons who are doing cases that are 2+ hours long....meaning that at any time there is an anesthesiologist sitting around waiting to start a case?

Come on lurkers....post up.

 

[Noyac]

Anyone out there in an all MD practice where your hospital is giving 2 rooms to surgeons who are doing cases that are 2+ hours long....meaning that at any time there is an anesthesiologist sitting around waiting to start a case?

Come on lurkers....post up.

We give 2 rooms to one surgeon only. He must post 6 or more cases and none of his cases are more than 2 hours. But still there is a lot of sitting around and I hate it. This surgeon is a good friend of mine and is a pleasure to work with. But I still hate it.

They must have a PA close the case so that the other room may bring the pt back and get started while the previous case is still finishing up and the surgeon will walk out to start the next case. This at least makes it effecient as possible.

 

[militarymd]

Over 100 looks and no other replies?

 

[UTSouthwestern]

No way. Two rooms only if the cases are an hour or less. We have five that we will provide double coverage to for their cases, because we know they will be quick.

 

[militarymd]

No way. Two rooms only if the cases are an hour or less. We have five that we will provide double coverage to for their cases, because we know they will be quick.

How do you define the length of the case...total patient time in the room, or total actual operative time?

 

[UTSouthwestern]

How do you define the length of the case...total patient time in the room, or total actual operative time?

Total time in the room. We guarantee 5-10 minute turnover between cases in each room if you guarantee that you can start the next case when we tell you the patient is ready.

 

[Noyac]

Total time in the room. We guarantee 5-10 minute turnover between cases in each room if you guarantee that you can start the next case when we tell you the patient is ready.

We try to do the same. We are working with some old attitudes and a lot of history in the current OR but we do follow this fairly well.

 

[UTSouthwestern]

We try to do the same. We are working with some old attitudes and a lot of history in the current OR but we do follow this fairly well.

Our solution is simple: Don't work quickly, don't expect two rooms. We can all still turn over a single room in 5-10 minutes providing the OR staff is quick with their equipment prep and patient prep, but we too would like to do 8-10 cases by noon - 1 pm and be done for the day.

 

[bubalus]

Dang, I thought my days of waiting for surgeons running two rooms (and the 2 hour academic lap appy) were going to be done when I finish residency. Just don't tell me there's no easter bunny or Santa Claus.

 

[frotteurism]

Our solution is simple: Don't work quickly, don't expect two rooms. We can all still turn over a single room in 5-10 minutes providing the OR staff is quick with their equipment prep and patient prep, but we too would like to do 8-10 cases by noon - 1 pm and be done for the day.

Wow...I admit that here in the academic residency world things don't go quickly, but 5-10 minutes seems hard to fathom...

Assuming I wake up the patient as the dressings are going on, it's probably five minutes to get the bed into the room, pt moved over and out the door. Another 10-15 to wheel the pt to the PACU, hook up the monitors, give report, close out the computer chart, and write PACU orders. Then, assuming the next pt is already there and has an IV (which is maybe 60% of the time) another 10 to see and examine/consent the pt, and even then the cleaning staff is still ten minutes away from having the room clean.

Bottom line, I think 30 minutes is about the fastest turnover I've ever seen at our hospital...

 

[UTSouthwestern]

Wake the patient as the dressings start to go on, 5 minutes to get the bed in, transfer, and move out the door, 1 minute to get to the PACU, preprinted PACU orders already signed, 1 minute to give report and write down first vitals, go pick up the next patient (IV started by preop nurses).

I speak to all of my patients the night before surgery. Interview done, listen to the heart and lungs for a few seconds, do an airway exam, and roll out the door. OR rotates sets of equipment so after patient leaves the OR, the cleaning crew wipes everything down and then the scrub, circulator, and aides open the next set, while the anesthesia tech resets your equipment (I draw up the drugs for the next case during the previous case).

5-10 minute turnover.

 

[UTSouthwestern]

Wow...I admit that here in the academic residency world things don't go quickly, but 5-10 minutes seems hard to fathom...

Assuming I wake up the patient as the dressings are going on, it's probably five minutes to get the bed into the room, pt moved over and out the door. Another 10-15 to wheel the pt to the PACU, hook up the monitors, give report, close out the computer chart, and write PACU orders. Then, assuming the next pt is already there and has an IV (which is maybe 60% of the time) another 10 to see and examine/consent the pt, and even then the cleaning staff is still ten minutes away from having the room clean.

Bottom line, I think 30 minutes is about the fastest turnover I've ever seen at our hospital...

Wake the patient as the dressings start to go on, 5 minutes to get the bed in, transfer, and move out the door, 1 minute to get to the PACU, preprinted PACU orders already signed, 1 minute to give report and write down first vitals, go pick up the next patient (IV started by preop nurses).

I speak to all of my patients the night before surgery. Interview done, listen to the heart and lungs for a few seconds, do an airway exam, and roll out the door. OR rotates sets of equipment so after patient leaves the OR, the cleaning crew wipes everything down and then the scrub, circulator, and aides open the next set, while the anesthesia tech resets your equipment (I draw up the drugs for the next case during the previous case).

5-10 minute turnover.

 

[Noyac]

We get it UT. You only have to say it once.

 

[UTSouthwestern]

We get it UT. You only have to say it once.

I actually checked the thread to make sure that the ghost post didn't find its way to the thread, but a few hours later, poof! It's there. 😱