Project Hospital – Surgery 101

This guide explains all you need to know about surgeries and how to have an efficient hospital process.

The Surgery Workflow

In order to have an efficient department, we need to understand the workflow and roles involved of surgeries in Project Hospital.

Every surgery procedure requires 6 or 7 (!) different roles, although the surgery in itself only requires 5 persons.

• A doctor as surgeon, who performs the surgery.
• A doctor as assistant to the surgeon.
• A doctor as anesthesiologist
• A surgery nurse
• A patient care nurse
• A patient transfer nurse
• (Optionally) A janitor to clean up

Assuming a patient is scheduled for a surgery, the workflow is:

1. Reserve the doctors and the surgery nurse and patient care nurse for the procedure.
2. The surgery nurse and patient care nurse head to the operating room.
3. The patient transfer nurse starts to transfer the patient from the ward to the operating room.
4. The surgery nurse and patient care nurse prepare the operating room.
5. The surgery nurse and patient care nurse pepare the patient.
6. The doctors head to the operating room and perform the surgery while the two nurses assist.
7. The surgeon, assistant and surgery nurse leave.
8. The patient care nurse and anesthesiologist prepare the patient for wakeup.
9. The patient care nurse stays with the patient and waits for the transfer.
10. The patient transfer nurse brings the patient back to the ward.
11. (A janitor can clean up now.)
12. The patient care nurse returns to the nurse station.

Staff roles and perks

From the workflow we can conclude which factors are important to determince the efficiency.

Findings from the workflow:

• 5 persons need to be reserved and stay reserved until the group is complete.
• The patient needs to be transferred back and forth by a patient transfer nurse.
• Patient care and surgery nurse work together.
• The three doctors work together.
• Patient care and patient transfer nurse work together.

Roles

The patient care nurse is reserved for the surgery, therefore the patient care nurse cannot also do the patient transfer!

While it is not necessary to have one nurse dedicated to each role, you need at least two nurses with both roles enabled. Should you have dedicated nurses though? This depends a lot on their perks. If you have a fast walking nurse, dedicate her to patient transfers. If you have a slow walking nurse, dedicate her to patient care or surgery nurse.

Everyone has to wait for a doctor doing diagnostics / observation. Therefore, if a doctor is allowed to do diagnostics / observation and has a surgery role, there should be another doctor with the same setup.

Second specialization – Allowed role
None Diagnostic / Observation + Assist at surgery
Advanced diagnosis Diagnostic / Observation + Assist at surgery
Surgery Surgery / Trauma
Anesthesiology Anesthesiology

Perks

W.I.P

Layout

Findings from the workflow:

• The patient transfer nurse is the only one who needs to walk to the ward for the surgery.
• Everyone needs to walk from the on call room / nurse station to the operating room and common room.
• Doctors need to walk to the operating room for every surgery, but only once in the morning to the ward.
• Patients are checked in and out from the ward.

The ideal layout

W.I.P