What Is Operating Room Orchestration?

Nov 20, 2019 8:00:00 AM / by Jag Padala, Chief Technology Officer

Are you wondering how operating room orchestration can improve OR patient flow and increase efficiency? Imagine a system that learns from the patterns and movements in the OR, applies rules and logic to improve workflows, and text to communicate updates. Here's how that would work, starting with a typical OR scenario and contrasting it with an orchestrated OR. 

A Typical Operating Room Scenario

Charge Nurse Carol looked up from her screen and noticed the patient getting wheeled out. She called out to the transporters to ask which room they had gotten the patient out of.

It was 3 pm on a Friday. It was a long weekend and most of her staff would not mind getting to their homes early. She still had a long way to go with at least a dozen more procedures lined up for the next three hours in her busy 12-room OR.

Coordinate EVS Cleaning

Carol needed to call the EVS cleaning crew to the room. They would call back as soon as they were done and then she would need to call pre-op to get the next patient in.

She had asked Fred to make sure all the procedure case carts were ready in the corridor but she was not sure they had made their way. Had she gone over to check the carts, she could have missed noticing the patient being wheeled out and it could have taken several minutes for someone to notify her that the room needed an EVS cleaning crew.

Manage OR Surgery Delays

When Carol looked at the board, she saw a hip procedure that was scheduled for 60 minutes. She has seen that procedure performed by the same surgeon multiple times and knew it would take at least 90 minutes. Consequently, she called the Pre-Op nurse and told her to expect to be at least 30 minutes late.

If she could have EVS waiting outside the room and if she could have the next patient prepped up, the team might be able to turn the room over a lot quicker than usual and still make the 6 pm time line. Her better option at this point was to open up a flip room to get the next patient into. One of the surgeries had gotten over quickly so she had a room empty. She took a couple of seconds to make up her mind and picked up the phone to request the flip room.

Carol was aware of the pressure on the OR to avoid overtime hours and she loved to do her part to make the OR director and department look good.

Making Room Turnover Targets

Running the OR was a complex task.

When a patient is wheeled out, Carol had a clock running in her mind to make the 25-minute room turnover target. In that time, EVS needed to go in to start cleaning the room and Anesthesia techs had to go in to setup for the next patient. Counts from the previous surgery needed to be closed out and new material needed to be taken out for the next patient.

Sometimes EVS would need to call a wet timeout if special cleaning was needed. Once the all-clear was given, procedure carts needed to be wheeled in and the next patient from Pre-Op needed to be transported.

With the holiday a number of her regular nurses were missing and she had to deal with staff that was new to her OR.

Enter TAGNOS OR Orchestration

Enter TAGNOS OR Orchestration

This scenario represents a pretty common theme in most OR units with many phone calls to manually alert others. This is where TAGNOS can make an impact on the load of OR nurses, making it easier to run operations smoothly.

TAGNOS OR Orchestration

Mobile Alert Systems

With TAGNOS mobile alerts, Carol doesn't need to call EVS. Rather, when the patient is wheeled out, EVS automatically gets a page and the team can go in by themselves.

Carol can also watch the room status change on a large screen or on her mobile. She can see the Anesthesia tech go in and come out after a while. Thanks to short cut codes on the mobile app, Carol knows when the Anesthesia tech is done.

EVS soon gives the all-clear using similar short cuts on their mobile. Carol can zoom in to see missing equipment and where it is so she can dispatch a nurse to get the equipment into the room.

Intelligent OR Patient Flow Planning and Preparation

The OR coordination starts long before this.

The TAGNOS Pre-Op board shows all the patients for the day and their status.

If any labs, imaging or H&P are missing, Carol would immediately know at-a-glance. The TAGNOS system can even SMS patients a few hours before the surgery to remind them to fast and not drink water before they get to the Operating Room.

When the patient is wheeled out, TAGNOS can inform family members via SMS.

Furthermore, TAGNOS can also monitor the environmental conditions in the OR room. If any variable is off that is shown as a lower safety score on the Post-Op dashboard, the Post-Op nurses would know to give more attention to that. If patients need isolation, the Post-Op board would clearly indicate this.

How Would You Prefer to Manage Your OR Patient Flow?

With no clear line of site, OR Charge nurses like Carol have a difficult time coordinating care using phone calls.

However, with optional automated inputs from RTLS sensors, scheduling feed from EHR and an AI/ML engine that can predict how long procedures will take, Carol could orchestrate her OR better with fewer phone calls, better turn around times and higher on-time starts, not to mention minimized overtime hours.

That's what TAGNOS does. It orchestrates the Operating Room, allowing care givers and charge nurses to do what they do best.

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About TAGNOS

TAGNOS is the future of clinical automation software solutions with Artificial Intelligence. TAGNOS is the only platform offering predictive analytics utilizing machine learning and RTLS. This groundbreaking platform leverages historical patient data continuously and adjusts operational intelligence to provide sustainable improvement to both the patient experience and metrics.

TAGNOS provides clinical systems integration, customizable reporting, dashboards, alerts, critical communication with staff and family to improve turnaround times. TAGNOS supports patient flow, workflow orchestration, and asset management. 

In the course of 13 months, hospitals see a 12.7% reduction in its overall cycle time - saving an average of 40 minutes from each case and over $1.6M per year - more than 11x the typical investment.

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