Improving OR efficiency by streamlining patient transfer in hand and upper extremity surgery

Background

Inefficiencies in the OR such as slow patient transfers can have a negative financial impact and affect patient safety. This study sought to determine whether decreasing the number of patient transfers in hand, wrist, and elbow surgery can improve patient flow from the time they arrive in the operating room to the time they arrive in the post-operative anesthetic unit (PACU).

Methods

Elective cases performed between April to August 2022 were retrospectively reviewed at two surgical centers. The pre-operative wait time (arrival time into the OR to the start of surgery); post-operative transfer time (end of surgery to when the patient leaves the OR); emergence time (when the patient leaves the OR to arrival in the PACU; and total patient flow time (entry into OR until arrival in PACU) were analyzed. Data from procedures where patients remained on their surgical bed (group 1) were compared against procedures where patients were transferred to and from the OR table (group 2).

Results

Data from 259 cases (group 1 n = 191, group 2 n = 68 cases) were collected. There were significant differences between: the pre-operative wait time (p < 0.001; 95% CI, 15:40 to 17:36); post-operative transfer time (p = 0.001; 95% CI, 3:25 to 5:59); emergence time (p = 0.02; 95% CI, 1:36 to 2:02); and total flow time (p < 0.001; 95% CI, 1:05:39 to 1:21:20). The average differences between the two groups in each phase are 3–9 min. There was no difference between the types of procedures performed (p > 0.05); the average difference in total flow time was 50 min.

Conclusions

Keeping patients on the same surgical bed for hand, wrist, and elbow procedures can help maximize OR efficiency in an outpatient ambulatory care setting.