The Antelope Valley Hospital is a 420 bed Level 2 trauma center. The Director of OR Services shared with me that they have 9 operating rooms, of which 8 are currently used on a daily basis. The first surgery starts at 7:30am and the patients start to arrive around 5:00am and are in the OR before their start time. After 5:00pm 5 rooms will run until 7:00pm. The hospital maintains 2 crews for surgery from 3:00pm-11:00pm, although only one OR will be used typically. The hospital will open additional OR’s as the volume increases. On the weekend 3 fully staffed OR’s are available on Saturday and 2 are available on Sunday. A Pixus for each OR is in place.
Scheduling is done on a first come first service basis and they are scheduled out about a week. It is easy for surgeons to get cases scheduled on the day they want or added on a day. You can get a room for the day and just keep going until you are done. The OR’s are well equipped. Should a piece of equipment be needed it will be bought. Anesthesia sedates for all procedures.
In some cases, a busy surgeon could be assigned OR 8 and OR 9 on the same day. This will allow them to have two OR’s and move quickly between the two OR’s and start their cases without waiting for the room to be cleaned. The normal turnaround time is about 30 minutes. They have 10 preoperative beds and 19 postoperative beds. Patients are wheeled over to surgery about 20 minutes before their case starts. Nurses usually insert the IV. Post Op has two-recovery areas-one for those under general anesthesia and the others from the conscientious sedations.
The OR uses Cerner as their EMR. The scheduling board in the OR hallway will list all the cases scheduled for the day including the type of case and anesthesia physician.
The anesthesia service is provided by MDA’s exclusively. They have 6 doctors on call, one in house 24/7 for the L&D unit and 3 for the OR’s. There is one doctor on call for trauma and one doctor on call for cardiac. They are scheduled on Saturday and Sunday and typically average about 10 OR cases on Saturday and 5 OR cases on Sunday.
The neurosurgery cases are less than 5% of the ANES volume. Most of the OR work is bread and butter surgery. The outpatient GI work is being done at the hospital. The inpatient GI procedures are done at the hospital.
There was $30 Million-dollar, 76,000 square foot renovation for the Woman’s and Infants Hospital (WIH). This is a 90-bed freestanding hospital on campus. Each room has windows for plenty of natural light. WIH has 18 LDR’s 4 OR’s, 9 private anti partum rooms, 39 private post-partum rooms (but wired for semiprivate if needed in the future) with couplet care (16 bed and 23 bed wing) and a 21 Bed Level 3 NICU. The LDR’s all have flat panel TV’s/DVD’s. There are 2 LDR isolation rooms and 2 handicapped rooms, which can also be used for VIP’s. There is a 10-bed pre/post op with skylights and 9 sleep rooms with separate male/female showers.
The OB department does about 5,000 deliveries per year and has OBs in house 24/7. The epidural rate is about 75%, and you can expect to do 7-14 deliveries per day when on call.
The NICU has glass walls and natural light in every room. Surgery can be done bedside or in the OR across the hall. There is a full isolation room and one room for multi-births. The only thing that gets referred out of the NICU is a few cardiac cases annually. They go to UCLA, Cedars Sinai, or LA Children’s Hospital. NICU is a closed unit and the pediatricians do not attend deliveries.
WIH has setup Cerner to monitor real-time bedside charting throughout the L & D unit. You will be able to log in remotely from your home, office, or PDA to view strips and patient records.