CST OR Efficiency & Case Flow 2 — Questions and Answers
Question 1: Which action most directly reduces OR turnover time between cases?
- Delaying room setup until the surgeon arrives
- Performing parallel processing by setting up the next room while closing is in progress (Correct answer)
- Waiting for full case count before beginning breakdown
- Having the circulator clean the room alone
Correct answer: Performing parallel processing by setting up the next room while closing is in progress
Parallel processing — preparing the next OR while the current case is still closing — is the single most impactful strategy for reducing turnover time.
Question 2: A surgeon's preference card lists a specific retractor that is unavailable. The FIRST action the scrub tech should take is:
- Substitute any similar retractor from the case cart without notifying anyone
- Notify the circulator so an acceptable substitute can be sourced or the surgeon informed before incision (Correct answer)
- Cancel the case until the item is restocked
- Document the shortage only after the case is complete
Correct answer: Notify the circulator so an acceptable substitute can be sourced or the surgeon informed before incision
Notifying the circulator before the case begins allows time to locate the item or communicate the substitute to the surgeon, preventing intraoperative delays.
Question 3: When does the scrub technician typically begin setting up the sterile field for the next case in an efficient OR?
- After the current patient has fully left the room
- Immediately after the final count is confirmed and while closing continues in the other OR (Correct answer)
- Only after terminal cleaning is complete
- Only when the surgeon personally requests setup to begin
Correct answer: Immediately after the final count is confirmed and while closing continues in the other OR
In a two-room or staggered-case model, the scrub tech sets up the next sterile field in the adjoining OR during closing of the prior case.
Question 4: What is the primary purpose of a standardized case cart system?
- To allow surgeons to request instruments intraoperatively without delay
- To ensure all required supplies and instruments are gathered and verified before the case reaches the OR (Correct answer)
- To eliminate the need for preference cards
- To replace the role of the sterile processing department
Correct answer: To ensure all required supplies and instruments are gathered and verified before the case reaches the OR
Standardized case carts are pre-assembled according to the surgeon's preference card so everything needed arrives with the case, minimizing last-minute runs.
Question 5: During case flow, 'first case on-time start' (FCOTS) is defined as:
- The patient entering the OR within 5 minutes of the scheduled time
- Incision occurring at or before the scheduled incision time for the day's first case (Correct answer)
- The surgeon scrubbing in before 7:00 AM regardless of schedule
- Anesthesia induction completed 30 minutes before scheduled start
Correct answer: Incision occurring at or before the scheduled incision time for the day's first case
FCOTS is measured by whether incision occurs on time for the first scheduled case of the day, as delays cascade through the entire OR schedule.
Question 6: Which item is the scrub technician responsible for reviewing BEFORE opening sterile supplies?
- The anesthesia record
- The surgeon's preference card and the procedure consent form to confirm correct procedure and side (Correct answer)
- The hospital's annual budget report
- The PACU nurse assignment sheet
Correct answer: The surgeon's preference card and the procedure consent form to confirm correct procedure and side
Reviewing the preference card and consent form ensures the correct supplies are opened for the correct procedure and laterality, preventing wrong-site or wrong-procedure setups.
Question 7: Which communication tool is MOST effective for maintaining OR efficiency when the schedule changes intraoperatively?
- Posting a paper update on the OR board only
- Using a real-time OR scheduling board visible to all team members with immediate updates (Correct answer)
- Phoning each room individually when a change occurs
- Waiting until the end of the day to reconcile schedule changes
Correct answer: Using a real-time OR scheduling board visible to all team members with immediate updates
A real-time visible scheduling system allows all staff to self-adjust priorities simultaneously, preventing communication gaps that delay cases.
CST OR Efficiency & Case Flow 2
Which action most directly reduces OR turnover time between cases?