DOOR-based schedules are taking safety and outcomes to new heights


Are there currently rooms within your OR that are not being filled on a daily basis? Or maybe there are too many after-hours cases occurring due to add-on cases? If you answered yes to either of those questions above, then OR management should consider the use of dedicated orthopedic operating rooms (DOORs). These rooms are defined as a daily, daytime, un-booked operating room that is staffed with experienced personnel. Compared to an idle room or even after-hour cases, these specific rooms offer improvements to many aspects of the OR.

            In addition to the effects in the OR, new research has found that DOORs also have direct benefits towards patients as well. The researchers assessed 111 patients with the main outcome measures being surgical timing, intervention type, perioperative complications, and postoperative length of stay. Results showed significantly lower instances of postoperative intensive care unit admissions, infections, and congestive heart failure. Due to those decreases, improvements to patient safety and outcomes occurred.

            Reduction in postoperative mortality and length of hospitalization is always a goal, and the use of DOORs can help management achieve that goal. Orthopedic patients benefit from having experienced orthopedic personnel assigned to one specific room, as it keeps teams working together in a well-rested non-disruption manner. The ability to perform such procedures during the daytime reduces post-operative complications, as this study recorded a 20% decrease.

            The facts surrounding these DOOR-based schedules should not be ignored. If rooms are being underutilized within your OR, or after-hour cases are becoming abundant, be sure to utilize this strategy. The economic benefits for the hospital and the lifestyle benefits for the patients will emerge. Committing the resources may initially be tough, but the paybacks will be abundant on the bottom line and satisfaction.

            What are your thoughts? Is this something that is feasible within your hospital? How do you think you would monitor a DOORs success? Would you use the same outcome measures that the research study above did? Would you include any other metrics?