Introduction of a New Work Process and Structured Communication System Reduces OT Turnover Time

By LEE Mei Yee RN, BSN, FHKAN (Perioperative), Nursing Officer
Operating Theatre Hong Kong Sanatorium & Hospital


The purpose of the project is to reduce Operating Theatre (OT) turnover time by introduction of a new work process and structured communication system. The aim is to improve physician, patient, and staff satisfaction.


Healthcare today faces many challenges, including rising costs. The OT is a particularly cost-intensive department. So, efficient usage of the Operating Room is critical. Surgeons and anaesthesiologists at Hong Kong Sanatorium Hospital reported concern about long turnover times in the OT.


Two 5-point scale surveys were given to OT nurses and ward attendants to identify factors which may contribute to long turnover times. Survey analysis showed that there was insufficient nurse staffing for room set up and case finalizing. In addition, there was unclear prioritization of operation room cleaning for ward attendants.

A new work process with structured communication system was implemented. A new position (Operating Room Coordinator) was established. With the new structured system, the circulating nurse calls the OR Coordinator once the OR team has started closing or 20 minutes before finish so that the OR Coordinator could aid in that critical moment.


Pre-intervention data was collected in March 2016. The data was restricted to all back to back cases except D&C and Endoscopy. Fifty-seven cases were collected. The mean turnover time was 30.8 minutes with a range of 13-61 minutes. Post-intervention data was collected in June 2016. Fifty-nine cases were collected. The mean turnover time was 14.4 minutes with a range of 6-30 minutes.


Implementation of the new OR Coordinators role has revealed some unique opportunities. The OR Coordinators are required to engage in all surgical specialties. As a result, these nurses have empowered themselves in areas where they identified weakness. In addition, one OR Coordinator was not enough for fifteen operating rooms. On occasion, the OR Coordinator would receive several calls simultaneously. It might be better to allocate more OR Coordinators according to the daily list.


Operating Theatre turnover time was shortened after implementation of the structured communication system and the Operating Room Coordinator role. It is anticipated that this program may improve physician, patient, and staff satisfaction.