Related Experiment Video
Updated: May 10, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Improving on-time start of day and end of day for a pediatric surgical service
Anna M Varughese1, Elena Adler, Amy Anneken
1Departments of Anesthesiology and Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA. anna.varughese@cchmc.org
Insights
Improving operating room (OR) efficiency in pediatric ENT surgery significantly reduced delays and overtime. Quality improvement methods boosted on-time OR completions from 40% to 60%.
Area of Science:
- Healthcare Operations
- Quality Improvement Science
- Pediatric Surgery
Background:
- Pediatric ear, nose, and throat (ENT) operating rooms (ORs) often experience delays.
- These delays cascade, leading to patient dissatisfaction and increased labor costs.
Purpose of the Study:
- To improve the percentage of ORs finishing on time in a pediatric ENT setting.
- The goal was to increase on-time finishes from 40% to 60%.
Main Methods:
- A multidisciplinary team implemented tests of change targeting case scheduling, medication ordering, and nurse availability.
- Data collection involved an independent collector and hospital IT systems.
- Statistical process control and control charts were used for analysis.
Main Results:
- On-time OR completion increased from 40% to 60%.
- Appropriate scheduling of complex cases rose from 10% to 87%.
- Accurate case duration scheduling improved from 21% to 48%.
Conclusions:
- Quality improvement methods successfully enhanced efficiency in pediatric ENT ORs.
- Improvements reduced patient wait times and institutional staff overtime.
Background And Objective:
In multicase pediatric ear, nose, and throat operating rooms (ORs), brief delays in early case start times often produce a cascading effect of lengthy delays by the end of the day and can often lead to patient, family, and staff dissatisfaction and increased labor costs due to unplanned overtime. We sought to improve actual end of day relative to scheduled end of day from 40% to 60%.
Methods:
Key drivers of the process included case scheduling, ordering of sedative medications, and nurse availability in the post anesthesia care unit to receive the patient from the anesthesia provider. A multidisciplinary team conducted a series of tests of change addressing the various key drivers. Data were collected by using an independent, impartial data collector as well as being extracted from the hospital information technology system. Data were analyzed by using control charts and statistical process control methods.
Results:
The percentage of ORs ending on time increased from 40% to 60%. Appropriate scheduling of complex cases increased from 10% to 87%, and accurate scheduling of case duration improved from 21% to 48%. Timely premedication increased from 55% to 90% and immediate availability of a nurse in the postanesthesia care unit from 68% to.90%.
Conclusions:
By applying quality-improvement methods, significant improvements were made in a multicase pediatric ear, nose, and throat OR. The impact can be significant by reducing wait times for patients, as well as staff overtime for the institution.
Related Concept Videos
01:15Chronopharmacokinetics: Circadian Rhythms and Influence on Drug Response
The time of drug administration is an important factor to consider, as it can influence the toxic dose of a drug. For example, a study conducted by Prins et al. in 1997 examined the effects of the timing of...
01:23Peripheral Artery Disease V: Postoperative Nursing Management
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion