Why I Stopped Accepting Workarounds in Perioperative Care

Why It Matters

Unchecked workarounds erode patient safety, inflate costs, and fuel clinician burnout, threatening the sustainability of surgical services. Addressing them restores efficiency, improves outcomes, and protects hospital revenue.

Key Takeaways

• Workarounds hide systemic inefficiencies in perioperative workflows
• Unaddressed documentation gaps cause cancellations and revenue loss
• Measuring and mapping real workflows reveals hidden risks
• Clinician-led operational decisions improve safety and efficiency
• “Good enough” standards increase burnout and patient harm

Pulse Analysis

Peri‑operative departments are plagued by invisible friction points that surface only when a patient’s chart reveals a missing piece of critical information. The reliance on ad‑hoc fixes—extra phone calls, duplicate data entry, and last‑minute clearances—creates a cascade of delays that directly impact surgical throughput and patient experience. Health systems that treat these workarounds as normal miss the opportunity to harness data‑driven insights that could streamline pre‑admission testing, reduce day‑of‑surgery cancellations, and safeguard revenue streams.

A practical path forward begins with rigorous measurement. By tracking metrics such as the time pre‑admission nurses spend chasing external records, the proportion of cancellations linked to pre‑existing chart alerts, and the incidence of unoptimized comorbidities at the time of surgery, leaders can quantify the hidden cost of inefficiency. Mapping actual workflows, rather than relying on idealized process maps, uncovers redundant steps and system silos that fuel workarounds. This granular visibility enables targeted interventions—integrating EHR modules, automating data pulls, and redesigning handoffs—to eliminate unnecessary clicks and phone calls.

Empowering frontline clinicians to shape operational decisions is the final catalyst for lasting change. When anesthesiologists and pre‑op nurses lead improvement initiatives, solutions are grounded in real‑world practice, driving higher adoption rates and sustained impact. Moving beyond a "good enough" culture not only reduces burnout and improves patient safety but also translates into measurable financial gains, positioning health systems to deliver higher‑quality surgical care at scale.