ACS First Start OR Protocol

Purpose

To ensure efficient utilization of operating room (OR) resources and timely case starts by outlining responsibilities for case reassignment at 6:00 a.m

Scope

Applies to all ACS surgeons, OR charge nurses, and ACS staff involved in scheduling and assignment OR cases

Proposed Plan

1.  Morning Check

• At 6:00 a.m., the OR charge nurse will review the schedule for OR 1.
• If multiple cases are scheduled in OR 1 and additional rooms are available, the OR charge nurse will text the attending surgeon who has the first-start case scheduled under their name

2. Case Reassignment by Surgeon Type

• Elective-case or Trauma Red Surgeons:
  • Upon receiving the text, the surgeon should direct the OR to move the next case (if scheduled under another surgeon) into the additional room.
  • It is understood that the surgeon will arrive in time for a 7:30 a.m. case start.
• Emergency General Surgery (EGS) Surgeon:
  • The EGS surgeon may choose which case to move into the additional room.
  • The moved case should be assigned under the CWIT surgeon.
• If No CWIT Surgeon Available:
  • If the CWIT surgeon is unavailable (e.g., already operating), the case should be assigned under the Trauma Blue surgeon.

3.  Coverage During Morning Hand-off

• During morning hand-off, if the CWIT or Trauma Blue surgeon is unavailable at the time of case start, an alternate covering surgeon will be identified.
• The OR charge nurse will be notified of the assigned covering surgeon.

4.  Surgeon Responsibility for Case Timing

• Any surgeon scheduling a case in advance who cannot be present to start the case as a first-start must indicate this during the case request process.
• This ensures the OR charge nurse will not move the case earlier inadvertently.

Compliance

Adherence to this protocol ensures timely starts and efficient use of OR resources.

Approved on 11/19/2025 by Dr. Charity Evans and Dr. W. T. Hillman Terzian