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Improve the Workflow:
Synchronize Surgical Case Start Time

Synchronize surgical case start time to a consistent, agreed upon point. For instance, use incision time to synchronize all of the processes leading up to the actual surgery, including patient registration, pre-anesthesia preparation, room set-up, and anesthesia. Once the synchronization point is defined and agreed upon, all processes can be timed with reference to that point.


Tips
  • Get people to see themselves as part of the same system in order to make the use of synchronization successful.
  • Use incision time as the synchronization point because: (1) all preparatory tasks must be completed at this time; and (2) after that time, synchronization is made easier because all providers are nearby.
  • Define tasks and lead times for each member of the surgical team relative to the incision time. For example, if incision time is scheduled to occur 90 minutes after arrival, nurse assessment is complete at 60 minutes before incision; anesthesiologist assessment is complete at 45 minutes before incision; the patient is brought to the operating room 30 minutes before incision; and incision occurs at "time zero."
  • Ensure that all staff use a common time reference. GPS or NTP network controlled clocks and count-down/count-up timers allow all time devices to be synchronized to the second thereby reducing the likelihood or inaccurate time notations of events. (John Edwards, Surrey, BC, Canada)