ACS First Start OR Protocol

First Start Operating Room 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 bookedcategoryed in OR 1 and additional rooms are available, the OR charge nurse will text the attending surgeon who has the first-start case bookedcategoryed under their name.

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 bookedcategoryed 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.

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.

Surgeon Responsibility for Case Timing

• Any surgeon bookingcategorying 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