Can a surgical assistant be a catalyst for efficiency in the operating room?

This article was originally written by Luis F. Aragon and published on the website of the National Surgical Assistants’ Association.

The goal of any operating room is to improve or maintain efficiency while providing positive outcomes for their patients. Therefore, if a surgical assistant is to be regarded as a crucial part of the team, their goal should align with those of the facility and surgeon.

Surgical assistant professionals should know what operating room administrators measure to create a value proposition that impacts those performance indicators positively and not just be seen as a supplier or vendor that can be commoditized.

  Although every individual operating room might have other metrics, the most often used performance indicators in an operating room are volume, utilization, operational metrics, and financial data.

Let us look at each one and how an efficient and valuable surgical assistant can favorably improve these indicators.

Volume indicators: Are the case load or volume and case length.

  • A surgical assistant can help increase the total number of cases
  • A surgical assistant can decrease the length of cases

Efficiency defined in an operating room is to perform a greater number of cases in a shorter period of time, ideally on shifts where no overtime is involved to minimize labor costs. (Day shifts)

A surgical assistant that is skilled and familiar with a surgeon’s preferences can be a significant catalyst to improve the indicators above and have an impact that could be measured.

Utilization indicators:

  • By day of the week – The goal should have a utilization rate of at least 75%-80% of the rooms busy.
  • By surgeon block or specialty.
  • After-hours utilization (Evenings, holidays, and weekends)

Although a surgical assistant is not able to directly impact these indicators, a valuable provider can indirectly help increase utilization by being consistently available, reliable, and providing the appropriate call coverage to the facility. Be a resource that the operating room team can always count on.

Operational indicators:

  • First case Starts: Directly, the surgical assistant can impact this indicator by always arriving on time. Being on time is defined as being 30 minutes prior to the scheduled case start. Unfortunately, one of the complaints from staff and OR managers is that the assistant arrives just seconds before the surgeon comes to the room.
  • Turnover time: Directly, the surgical assistant can impact this indicator by helping staff with turnover if they have cases back-to-back in the same room. Also, if the scope of practice allows by helping to open supplies, doing the count, etc. The job of a surgical assistant is to be an assistant to the operating room team as well as the surgeon.
  • On-time starts: Directly, the surgical assistant can impact this indicator by always arriving on time. Again, being on time is 30 minutes before the scheduled start time.
  • Cancellations: No indirect impact by a surgical assistant unless the assistant does not show up.
  • Add-ons: No indirect impact by a surgical assistant.
  • Overtime: See the Volume indicator above.

Financial indicators:

  • Contribution margin: A surgical assistant can impact this margin depending on the type of provider, if the assistant is employed or outsourced; if outsourced, if the patient is commercially insured or not, etc.
  • Medical supply cost: The surgical assistant can impact this metric only if he/she is proactive and familiar with the surgeon and his preferences to help determine that the OR staff does not open supplies that are unnecessary or are only optional. This comes by the assistant being consistent and knowledgeable of the surgeon’s preferences and facility policies.
  • Clinical hours per case: If the surgical assistant is a team player, as it should, and physically present in the room when the patient is wheeled in, and proactive, he/she can minimize the time other clinicians spend with the patient by assuming tasks that are in their scope of practice at the facility.
  • Excess staffing costs: See contribution margin and volume indicator above.

Conclusion: A surgical assistant can be an integral part of the efficiency of an operating room if the communication and knowledge of what metrics are essential have been discussed and aligned with all stakeholders.

A valuable surgical assistant can increase case volume, decrease case length, increase room utilization, improve operational metrics, and contribute positively to the financial indicators if the proper structure and processes are in place, especially if the communication between operating room management and surgical assistant staff; in-house or outsourced is open and transparent.

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