The OR desk phone number is 3-5631. We are here for you 24/7. We are your allies in providing quadruple aim, expedient care to our patients. We have compiled some miscellaneous tips to simplify OR access.
Please call the scheduling office at 3-6954 to post cases Monday through Friday 8am to 5 pm.
Please post cases through the OR desk for all same-day postings and for next-day postings if it is after 5pm.
If it is Friday after 5p through Monday at 8 am and you need to post a case for Saturday, Sunday, or Monday, please call the OR desk.
If calling the scheduling office to post cases during off-hours, please leave the patient’s posting information, including any special items/equipment needed, on their answering machine. They will post the cases in the order received, so the patient’s place in line will be preserved. Leave your contact number and any time constraints on the message.
To book an anesthesia sedation case:
All sedation cases must be NPO.
You must discuss the patient with the anesthesia board runner (8-0082).
For all other anesthesia sedation bookings, please call scheduling.
Things to Know (and Ways to Help Us Help You)
Attending surgeons may only run two ORs at once. If a third room must be opened, an alternate attending must engage.
Attending surgeons may never have cases running simultaneously in different buildings. For example, one attending cannot cover a case at the VA or CAS while covering a case at Chandler.
Do not engage the OR before your attending is aware of and agrees to the case or before the patient has consented unless it is a class A emergency. This will prevent wastes of time and resources.
Aside from some A emergencies, all patients must be consented and have an updated H&P. Inpatient consents are good for 48 hours. Outpatient consents are good for 30 days. H&Ps are good for 24-hours and must include a statement regarding the plan to bring the patient to OR on that date. Anesthesia must also consent every patient. Please keep this in mind if there are language barriers or social issues- sometimes a phone call to OR to let us know the power of attorney is available, for example, can avert a delay of your case.
When 2+ services plan coinciding procedures on a patient, each service must post their portion of the case with the scheduler. Posting cases correctly and with all involved parties included in the booking at the time of posting allows the OR to provide the correct supplies, estimate surgical time, and allows each service access to chart on the operative record. Adding procedures later will cause many avoidable problems and inevitable delays.
At the time of posting, please give the scheduler a list of special items/equipment needed for the case. The more the OR knows before the patient is in the room, the smoother the case will go. If there are extenuating circumstances regarding your patient (i.e. they are on ECMO), please inform the OR when posting.
While situations and provider preferences differ, the general rules for NPO status are as follows:
2 hours: clears, including clear juices, black coffee, and tea
4 hours: breast milk
6 hours: plain toast, non-breast milks, coffee with cream
8 hours: most solid foods, juices with pulp
If the patient has NG tube feeds that have not been turned off, it may be possible for the case to go without waiting 8 hours if the tube is post-pyloric (with day-of-surgery imaging to verify tube placement).
On Saturdays, there is one room for scheduled elective cases from 7:30 am – 3 pm. Any service can book into this room. Aside from this block, all other weekend cases are considered elective or TSA cases (time/space available) and will be taken care of in the order they are scheduled.
Please, refrain from making repeated calls to the desk regarding estimated start times for TSA cases. The schedule is ever evolving and is always only a phone call away from the next change in plans. This makes it difficult to forecast when a non-emergent case might go. Please know we are aligned with you in getting all surgical patients timely care. When we send for your service’s patient, the desk will call the resident listed on the posting.
If the OR is ready to start your case and the patient is not ready for surgery (i.e. lacks consent and POA not present or the patient is waiting for scan or labs, etc.), the case will go to the bottom of the list. Please avoid engaging the OR if your patient or team is not ready.
Please make every effort to post cases correctly. A great deal of time and resources are wasted if, for example, a case is posted as an open case when it is actually a laparoscopic case.
Cases cannot be posted as place holders- meaning that as long as any other cases are in the queue, a service cannot cancel a case and replace it with another. If a case cancels, the time slot goes to the next waiting patient. There are times we may be able to accommodate, but this is the general rule.
If you need OR supplies for an off-site procedure, please call OR Materials at 3-8080. They might even be able to tube supplies to you if you provide them with the closest pneumatic tube station number. Other helpful contacts:
Central Sterile (instruments) 3-6026 Hospital Materials 3-5645 Emergent Cases
There are formal rules of engagement for posting emergent cases to OR under Policy #OR01-07, but here is the gist:
Please do not post an emergency to OR until the surgeons are available and the patient is consented and ready for surgery. Cases are considered active emergent postings only once both patient and service are 100% ready for OR. For example, a case cannot jump the list by being posted as an emergency 4 hours before the attending will actually be available. Likewise, if the OR is available and a viable emergent case is posted, it will go as quickly as possible; so, case cannot be posted at 0530 as a B emergency with the expectation of waiting to go to OR until 0730 as a first start.
Emergent case status is related to patient status alone and has nothing to do with convenience or availability. For example, a case cannot be posted as an emergency to follow the last case in a line. Additionally, a service cannot post a case today with the intention of it going as an emergency tomorrow because that is when the attending will be available. The attendings of every service convened to decide what sorts of cases would be considered emergent for their respective services. The OR desk is happy to provide copies of these case listings.
The categories of emergent cases are as follows:
Trauma Red:
Requires immediate access to OR
Never bring a trauma red up to OR without first calling the OR. The desk MUST
have a medical record number, at the very least. Imagine how much better the care your team can provide when you know a trauma patient is on the way rather than having them just show up unannounced in the trauma bay. Similarly, OR needs notice in order to provide both our best care for the patient as well as optimal support for you. The more notice and information shared, the more prepared we can be.
A full posting is not required if time does not allow, but it helps the OR to help you if we know the general area of the surgery and/or the mechanism of injury
If there is a trauma red page, the OR will hold a room/team for 1 hour- until someone from the trauma service calls the desk to either post or clear the red, or extend the hold time. This communication is key. SGB must call the desk to either engage or release the OR. Telling anesthesia personnel DOES NOT negate your responsibility to communicate with the desk.
Class A Emergency:
Life or limb-threatening condition requiring immediate surgery
Will take precedence over and bump any other case
OR has a 1 hour time limit to get an A emergency patient in the room
If the patient needs to come to OR immediately, please discuss using the trauma
room with the desk.
A emergencies cases can post without consent if required by the acuity of the
patient
Class B Emergency:
Life or limb threatening condition requiring surgery within 4 hours
B emergencies become A emergencies after 3.5 hours
Non-life-threatening condition which may lead to severe complications without surgical intervention within 24 hours
Administrative T Emergency:
Cases after which the patient can be discharged home, facilitating throughput
Case Bumping
Emergent cases go ahead of (or “bump”) TSA or scheduled cases.
If you have TSA patients who have been bumped for one or more days, please make OR charge aware. We will try our best to make them a priority. If a patient declines, the posting can be upgraded to emergent status. Please know that it is not considered a bump if the service chooses to takes the case off the schedule because it is late in the day.
If you add an emergency, it will bump your service’s other cases. Unless both OR and Anesthesia can open an additional room, the added emergency will go before your service’s scheduled line. If a case is posted as an emergency and the service chooses to do a non-emergent case first, the emergent posting loses its status.
If your attending believes your case is more emergent than that of another service, the attendings must decide between them who will go and let the OR desk know. This is a conversation between the service attendings (the anesthesia attending may be involved as well) and does not include the room’s nursing or anesthesia staff, or the OR desk. If consensus is not reached, the matter will be escalated to the Medical Director who will make the final decision.
Whether bumping a partner or another service, it is your responsibility to talk to the attending/service being bumped.
