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Deliberate perioperative systems design improves operating room throughput.

Warren S Sandberg¹, Bethany Daily, Marie Egan

¹Harvard Medical School, Boston, Massachusetts, USA. wsandberg@partners.org

|July 30, 2005

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Redesigning operating room (OR) workflows by parallelizing tasks and relocating non-OR activities significantly improved patient throughput and reduced time per case. This enhanced efficiency offset increased costs, maintaining overall financial margins.

Area of Science:

Healthcare Operations Research
Surgical Workflow Optimization
Perioperative Process Improvement

Background:

Traditional operating room (OR) designs prioritize the physical environment over care processes.
There is a need to enhance OR throughput and reduce case times through strategic design.

Purpose of the Study:

To improve operating room (OR) throughput and reduce time per case.
To achieve this through goal-directed design of a demonstration OR and associated perioperative processes.

Main Methods:

Constructed a three-room suite: OR, induction room, and early recovery area.
Ran traditionally sequential activities in parallel and moved nonsurgical tasks out of the OR.
Supported the new workflow with additional anesthesia and nursing staff.

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Utilized a retrospective, case- and surgeon-matched design for performance comparison.

Main Results:

The new OR processed more cases per day and used less time per case compared to traditional ORs.
Nonoperative Time was significantly reduced from 67 minutes to 38 minutes.
Operative Time decreased by approximately 5%.
Increased throughput offset increased hospital and anesthesia costs per case, maintaining the net margin.

Conclusions:

Deliberate redesign of OR and perioperative processes demonstrably improved patient throughput.
Performance gains resulted from relocating and reorganizing nonoperative activities.
While incurring additional costs, the improved OR throughput accommodated more patients and generated revenue, balancing expenses.