Background The average cost of running an operating room (OR) is approximately $37.00 a minute. Therefore, every effort should be made to start in a timely manner. There are several factors at play that can cause OR delays. Attaining consistent start times is a multidisciplinary task, which requires good communication and rewards for efficiency. Methods At our institution, a “star system” was implemented to improve compliance with timely start times. All OR staff (scrub tech, OR nurse, anesthesiologist, and physician) get 1 star for every on time start. Once a person attains 10 stars, they are awarded a $20 gift card to a local bakery/coffee shop. Results There was a significant difference in the 3 months pre- and post-implementation of the star system in regard to starting on time (54% vs. 71%, P-value .047), and there were significantly less late starts within 6-10 minutes (14% vs. 4%, P-value = <.01). There was no statistically significant difference in late starts >11 minutes or when comparing days of the week. The most common reasons for delay are as follows: surgeon running late (23%), anesthesiologist tardiness (11%), patient is late (9%), preoperative orders, or test not completed (7%). Conclusion The significant increase in the number of cases that start on time after implementation of the star system leads us to believe that late start times are multifactorial, and that incentives are a positive way to encourage the OR team to start on time.
Nurses work closely with residents on a daily basis but may not understand the details about residency training and experience. We investigated our institution to understand misconceptions nurses may have about residents and provide education. Nurses (n = 26) participated in a lecture about residents and were given identical surveys before and after the lecture. Twenty-two nurses (85%) were medical/surgical, 1 (4%) was obstetrical, and 3 (11%) were critical care. In the pre-education survey, nurses were able to correctly identify the main purpose of residency as educational. Most nurses knew that residents arrived at the hospital between 5:00 and 7:00 am and that residents could perform bedside procedures. A marked increase was found between correct pre- and post-survey answers in 4 questions: interns are doctors (15% vs. 77%), residents’ work hours (23% vs. 65%), correct average salary (39% vs. 92%), and correct paid time off (PTO) days per year (8% vs. 85%). Salaries were overestimated, and work hours and PTO were underestimated. Most nurses did not know interns are in fact doctors. Our post-educational survey demonstrated improved knowledge of resident credentials, challenges, and work environment. The mean result for the post-educational survey was significantly higher than the pre-educational survey results, indicating that the educational intervention was effective in improving nurses’ knowledge regarding residents.
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