Pre-Op Pitfalls: Investigating Delays in Surgical Start Times at A Large Medical Center

Abstract

This study investigates an overlooked contributor to operating room (OR) delays: the pre-operative (pre-op) phase. As a critical step requiring multi-divisional coordination, identifying systemic breakdowns during this phase may streamline surgical care. Researchers shadowed nurses through pre-op care for first-start cases to track timing and workflow. Focus groups were conducted during which various OR staff members discussed their routines, identified challenges, and suggested improvements. Nine of the 12 observed cases were delayed, with average delays on each OR floor (n = 3) ranging from 8 to 24 min. Delays were attributed to poor team coordination, electronic health system issues, staffing shortages, and patient factors. Improving OR turnover rates requires strategic staffing, reliable electronic health systems, and effective team coordination during pre-op processes. The variability in workflows and challenges of different OR floors of the same healthcare center highlights the need for tailored interventions rather than a uniform approach.