Turnover

Turnover is really important in the operating room. While patient care takes the first and foremost priority, when we are in between cases, efficiency becomes king. Once a patient is out of the operating room, the entire place needs to be cleaned and disinfected, the anesthesia cart restocked, the next case cart readied, and surgical equipment prepared. The goal is to have all this done within 15 minutes. From an anesthesia perspective, I need to bring my patient to the recovery room, make sure she is stable, sign out to the nurse, dispose of any opiates properly, finish documentation, meet my next patient, review the history and physical, place an IV, and then prepare all my equipment and drugs. Surprisingly, the most quiet time for an anesthesiologist may be during a case and the most hectic time that period from extubating one patient and intubating the next.

At Stanford, we even have outside consultants who look at our processes to try to optimize them. We get occasional emails telling us how different checklists have been changed, why we aren't getting our patients to the operating room soon enough, and displaying graphs on our efficiency. I don't particularly like it, but I recognize that this is the way to make things operate more smoothly which can ultimately save resources and make everyone happier.