Why the study?
Improving OR first-case on-time starts is a multifactorial challenge, and delays prevented the organization from meeting its adherence goal of 80% or higher.
Does implementing a preoperative time-based target for perioperative nurses reduce first-case on-time start delays?
Does implementing a preoperative time-based target for perioperative nurses reduce first-case on-time start delays?
Implementing standard work documents with preoperative time frames for perioperative nurses significantly reduced first-case on-time start delays and improved compliance, resulting in cost savings.
May aid FCOTS adherence via standard work in one ambulatory center; leaves open generalizability and durability.
Improving OR first-case on-time starts (FCOTS) is a multifactorial challenge for perioperative nurses and leaders seeking to improve efficiency. This article describes the implementation of a quality improvement project at a hospital-based ambulatory surgery center to decrease FCOTS delays, which did not allow the organization to meet its FCOTS adherence goal of 80% or higher, averaging 59% in 2023. Through the creation and adoption of standard work documents to reduce variability, nurses were given a preoperative time frame within which to complete the nursing components required to prepare a patient for the OR. When comparing intervention and baseline data after the three-month intervention period, a significant reduction in total minutes delayed was noted-from 1,422 to 799 minutes (P < .001)-as well as an improvement in FCOTS compliance to 82%. Estimated cost savings were $35,111 for the three-month intervention period, demonstrating that modifications to nursing workflows alone can improve perioperative efficiencies.
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Crumley et al. (2025) studied this question.