Surgical Services in Crisis: Managing OR Schedules and Procedures Without IT

Surgical departments rely heavily on IT systems to coordinate patient care, manage schedules, and ensure safe, efficient procedures. From digital scheduling systems and electronic medical records (EMRs) to anesthesia tracking and surgical inventory management, technology is woven into every step of the perioperative process. So, what happens when those systems suddenly go dark?

An IT outage in surgical services can create a logistical nightmare—schedules become unclear, critical patient data becomes inaccessible, and supply chain management is disrupted. Without a clear downtime response plan, surgical teams risk procedural delays, missing key patient safety checks, and facing operational bottlenecks that could jeopardize both routine and emergency procedures.

Hospitals must have a clear, well-rehearsed strategy for maintaining surgical operations when IT systems fail. Here’s how healthcare organizations can keep operating rooms functional and safe during a digital blackout.

The Impact of IT Downtime on Surgical Operations

When IT systems fail, surgical teams encounter a cascade of operational challenges, including:

• Uncertainty in Case Scheduling – Without access to surgical scheduling software, determining procedure order and priority becomes chaotic.

• Limited Access to Patient Records – Surgeons and anesthesiologists may not be able to review past procedures, allergies, or pre-op test results.

• Disruptions to Equipment and Supply Management – Automated tracking of sterile surgical instruments and implantable devices may become unavailable, increasing the risk of missing necessary tools.

• Breakdowns in Communication – Surgical teams rely on IT systems for real-time updates, changes in patient condition, and anesthesia monitoring integration.

A failure to manage these disruptions efficiently can lead to serious consequences, such as delays in emergency surgeries, increased infection risks, and potentially avoidable complications.

Strategies for Managing Surgical Services During an IT Outage

1. Implement a Manual Scheduling and OR Assignment System

One of the first challenges in an IT outage is determining which cases are scheduled and how they should be prioritized. Without access to scheduling systems, surgical teams should revert to a structured manual workflow:

• Print and maintain physical copies of the surgical schedule at the start of each day in case of an outage.

• Use a whiteboard or designated downtime schedule binder to track ongoing cases and update priorities based on urgency.

• Have a designated OR coordinator manually track case status and relay updates between surgical teams.

By keeping a clear manual record of scheduled and completed cases, hospitals can minimize confusion and prevent procedural delays.

2. Ensure Access to Paper-Based Patient Records and Pre-Op Documentation

Surgeons and anesthesiologists need access to a patient’s history, test results, and allergies before proceeding with surgery. During an IT outage, hospitals should:

• Prepare printed summaries of all scheduled patients’ key pre-op data, including lab results, imaging reports, and allergy documentation.

• Ensure downtime folders for each patient contain consent forms, surgical notes, and physician orders.

• Require verbal confirmation and double-checking of patient identity, procedure type, and laterality (right vs. left) before every surgery.

A well-organized manual documentation process ensures that no critical patient information is lost during an outage.

3. Maintain Medication and Anesthesia Safety Without Automated Systems

Anesthesia management is highly dependent on IT systems for medication dosing, patient monitoring, and real-time vitals tracking. If an outage disrupts these systems:

• Anesthesia providers should revert to manual tracking of medication dosages, times, and vitals, recording information on a downtime anesthesia record.

• Double-check all high-risk medication calculations manually, ensuring a second provider verifies dosages before administration.

• Ensure backup battery-powered monitors are operational and available for continuous patient tracking in the OR.

Failing to have a structured manual backup for anesthesia processes can lead to serious patient safety risks.

4. Establish Clear Workflows for Surgical Supply and Instrument Tracking

Modern surgical departments rely on IT-based inventory systems to track sterilized instruments, implantable devices, and disposable surgical supplies. When these systems are offline, hospitals must:

• Use pre-prepared case carts for scheduled surgeries to ensure that necessary instruments are available without IT assistance.

• Manually log instrument use and reprocessing status to prevent sterility lapses and tracking errors.

• Designate supply chain runners to retrieve additional surgical tools or medications as needed, ensuring continuous flow of materials.

By maintaining a downtime inventory management protocol, surgical teams can avoid procedural delays and maintain patient safety.

5. Strengthen Communication Between OR Teams, Nursing, and Support Staff

Communication breakdowns during an IT outage can be devastating in an OR setting, where timing and coordination are critical. Hospitals should implement:

• A central communication hub for surgical coordination, such as a dedicated OR command center.

• Two-way radios or overhead paging systems for real-time updates between the OR, pre-op, and post-anesthesia care unit (PACU).

• A designated runner system to relay messages, lab results, and supply requests between departments.

With strong alternative communication methods, hospitals can ensure that surgical teams remain in sync despite IT challenges.

Transitioning Back to Normal Operations After an Outage

When IT systems are restored, the focus must shift to verifying, reconciling, and re-entering manually documented patient information. Hospitals should:

• Cross-check all surgical records entered manually with digital records to ensure accuracy.

• Audit medication administration records for completeness before resuming normal workflows.

• Conduct a post-incident debrief with surgical leadership and IT teams to evaluate what worked well and what needs improvement.

A structured post-outage review ensures that hospitals learn from the event and refine their downtime preparedness strategies.

Final Thoughts: Preparedness is the Key to Surgical Continuity

An IT outage in surgical services is not just a technical inconvenience—it is a serious operational risk that can impact patient safety, procedural efficiency, and clinical outcomes. Without access to digital scheduling, records, and supply tracking, OR teams must be prepared to adapt quickly and confidently to a manual workflow.

Hospitals that invest in downtime training, establish well-documented manual workflows, and reinforce cross-team coordination will be far better equipped to handle IT failures without compromising patient care and surgical efficiency.

Is Your OR Ready for an IT Outage?

At Stone Risk Consulting, we help hospitals develop comprehensive OR downtime strategies that ensure continuity in surgical operations, protect patient safety, and maintain compliance. Contact us today to assess your hospital’s preparedness and optimize your surgical resilience plan.