“In most hospitals the circulating nurse interviews the patient then waits with them and pushes them back to the OR. At our facility the circulating nurse goes out and interviews the patient and says, ‘I am going back to the OR now to help ensure that everything is ready for you.’ It is the anesthesia provider who pushes the patient back to the OR. Patients who receive sedation must be continuously monitored, so this works out well. In addition, the anesthetist has a few extra minutes with the patient to bond and answers any questions that might help put him or her at ease.”
The Circle of Surgery…
“When the case is done, the anesthesia provider and circulator go out and give a short report to the family, then the circulator immediately goes to preop for the next patient. It is essentially a circular process.”
“The anesthesiologist knows when Dr. Lombardi is starting to cement the knee and he calls preop so to start anesthesia for the next patient. At that point you have about 15 more minutes in the OR before the surgeon’s physician assistant (PA) begins final incision closure. During the 15 minutes the PA is closing the incision the doctor is speaking with the patients family to inform them how the surgical procedure went, entering patient orders, dictating the surgical case, and marking the site for another upcoming patient while the staff members are positioning, prepping and draping the next patient who was blocked 20 minutes earlier.”
“We are proud that visiting healthcare teams come from all over the world say, ‘Nobody’s scurrying around here…it’s like a symphony.’ And it all works because everyone knows everyone else’s job, as well as the timing of those roles.”
Diane Doucette: “We tell surgeons, ‘You are the conductor…make it great.’”
