Clinical Issue: As a key department within a healthcare organization, the operating room is a hazardous environment, where the consequences of errors are high despite the relatively low rates of occurrence. Under-utilized Operating Rooms (OR)and unpredictable staffing patterns lead to increased operating costs of the surgical department. Communication and collaboration by the key stakeholders can provide the necessary support required by the operating room teams to prevent staff burnout, offer a predictable work life balance and provide an optimal, safe and quality patient care.Description of Team: A multidisciplinary team consisting of the OR nurse manager, clinical supervisors and team leads initiated daily afternoon huddles.Preparation and Planning: Under utilized OR's along with unpredictable staffing led to increased operating costs of the surgical department. Careful scrutiny of the surgical schedule with its last minute schedule changes was necessary to accommodate the increased growth, reduction of overtime hours and lessen staff dissatisfaction. An easily adaptable communication method was essential to address the imbalance of case distribution and surgical resources throughout the surgical suite.
Assessment: The surgical services department has experienced substantial growth in elective caseloads after normal business hours (5pm). Staff were requested to work outside their clinical expertise in order to accommodate fluctuations in surgical case volumes leading to staff dissatisfaction and compromise of optimal patient care. Lack of interdepartmental communication was found to result in the OR utilization inefficiencies and unpredictability of a normal business day.Implementation: Daily huddles were initiated at 2pm for reassessment of surgical demands later in the day. The primary focus of this huddle was to enhance utilization of resources for the late scheduled and/or emergent surgical cases. Assessment of staff skills and an analysis overtime and OR utilization was tracked to assist in the requests for additional resources.Outcome: The huddle initiative proved to be an efficient and effective method of communication. The findings were presented to the surgical teams at a meeting reinforcing the value of cross training which afforded the opportunity for professional and personal development. Completion of the daily schedule by 7pm afforded a more predictable work life balance for staff and patient throughput.Implications for peri-operative nursing: A collaborative leadership team was the driving force to facilitate practice change from the afternoon huddle. This initiative has been incorporated in the daily workflow resulting in effective management of increased work volume and offer staff predictable work hours. This intervention across the surgical services department brought about broad cultural changes across specialty services and positively impacted staff engagement and in the pursuit of quality and safe patient care.