[Operating room management]

The changing health care climate has triggered important changes in the management of high cost components of acute care facilities. By integrating and improving management of various elements of the surgical process, health care institutions are able to rationally trim costs while maintaining high-quality services. If the results of surgery are viewed as a product, everything associated with surgery can be evaluated as one would a manufacturing process. All steps involved in producing the end result can and should be analyzed with the goal of producing an efficient, economical and quality product. The leadership that physicians can provide is crucial to the success of this undertaking. The role of the anesthesiologist in the management of the operating room setting (OR) has gained broad acceptance because: a) it contributes to the effort of a larger team process; b) the anesthesiologist ordinarily practices in the OR setting; and c) the anesthesiologist can view the priorities of the OR in an unbiased manner. Many of the successful concepts in managing an OR are just common sense. The single best opportunity for dramatic improvement in effective resource use in Surgical Services lies in the perioperative process. The management strategy must focus on process-measurement using information technology and feedback implementing modern quality management tools. The impact of new treatments, drugs, devices and process changes can be assessed rationally.