Discovering the barriers to efficient robotic operating room turnover time: perceptions vs. reality

J Robot Surg. 2020 Oct;14(5):717-724. doi: 10.1007/s11701-020-01045-y. Epub 2020 Jan 13.

Abstract

Turnover time (TOT) has remained the subject of numerous research articles and operating room (OR) committee discussions. Inefficiencies associated with TOT are multiplied when complex technology, such as surgical robots, is involved. Using a human factors approach, this study investigated impediments to efficient robotic TOT and team members' perceptions surrounding this topic. Researchers observed 20 robotic turnovers over 2 months at a tertiary hospital. TOT, cleaning time, number of staff present, bed set-up time, instrument set-up time and any major delays were recorded. Additionally, 79 OR team members completed a questionnaire regarding perceptions of OR turnover. Average TOT was 72 min (s, 24 min). Overall, cleaning required the most time (average of 27.4 min, 37.96% of TOT), followed by instrument set-up (15.4 min, 21.34% of TOT) and RN retrieval of the patient from pre-op (12 min, 17.72% of TOT). OR team members estimated that turnovers require 60.36 min. Physicians believed the greatest contributor to TOT was "time to set up the OR", while OR staff rated "instrument availability" as the greatest issue, both of which were inaccurate. OR team members' perceptions of robotic TOT and contributing factors were different from reality based on observed contributors. Data demonstrated several areas of opportunity for process improvement. These data can be used to guide the implementation of targeted interventions to improve TOT efficiency.

Keywords: Human factors; Operating room; Quality improvement; Robotic surgery; Turnover time.

MeSH terms

  • Appointments and Schedules*
  • Humans
  • Medical Staff / psychology*
  • Operating Rooms / statistics & numerical data*
  • Patient Care Team*
  • Perception*
  • Preoperative Care / statistics & numerical data
  • Quality Improvement
  • Quality of Health Care
  • Robotic Surgical Procedures / psychology*
  • Robotic Surgical Procedures / statistics & numerical data*
  • Surveys and Questionnaires
  • Time Factors