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Developing a high-efficiency operating room for total joint arthroplasty in an academic setting.
David E Attarian1, Jennie E Wahl, Samuel S Wellman
1Department of Orthopaedic Surgery, Duke University Hospital and Health System, Duke Medicine Plaza-Page Road, 4709 Creekstone Road, Suite 200, Durham, NC 27703, USA. david.attarian@duke.edu
Clinical Orthopaedics and Related Research
|December 5, 2012
Summary
Implementing process analysis and teamwork significantly boosted operating room (OR) efficiency for total joint arthroplasty (TJA). This led to more on-time starts and reduced turnover times, increasing TJA cases per OR.
Area of Science:
- Healthcare Operations Management
- Surgical Workflow Optimization
- Academic Medical Center Efficiency
Background:
- Academic operating rooms (ORs) face challenges in efficiency due to established work cultures and departmental silos.
- Ensuring financial viability requires academic institutions and surgeons to adopt strategies for increased productivity.
Purpose of the Study:
- To identify resources and personnel for total joint arthroplasty (TJA) ORs.
- To assess and address work process delays.
- To improve OR efficiency metrics like on-time starts and turnover times for increased TJA case volume.
Main Methods:
- Collected 1 year of retrospective TJA OR time data and 1 month of prospective workflow observations.
- Presented findings to a multidisciplinary committee for recommendation formulation and implementation.
- Employed strategies including dedicated efficiency teams, parallel processing, dedicated resources, and modified physician behavior.
Main Results:
- On-time OR starts improved from <60% to >90%.
- Average OR turnover time decreased from >60 minutes to 35 minutes.
- Average TJA cases per OR increased by 29%.
Conclusions:
- The project successfully enhanced OR efficiency and productivity.
- Key strategies involved process analysis, resource optimization, improved communication, and collaborative teamwork.
- Overcoming silo mentalities was crucial for achieving improved outcomes.