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Improving operating room turnover time: a systems based approach.

Ankeet S Bhatt1, Grant W Carlson, Peter J Deckers

  • 1University of Connecticut School of Medicine, 263 Farmington Ave, Farmington, CT, 06032, USA, abhatt@student.uchc.edu.

Journal of Medical Systems
|November 9, 2014
PubMed
Summary
This summary is machine-generated.

Implementing a new operating room (OR) process significantly reduced OR turnover time (TT) by over 35%. This systems-based approach improved efficiency and reduced variability in patient readiness and room turnover.

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Area of Science:

  • Healthcare Management
  • Surgical Operations
  • Process Improvement

Background:

  • Operating room (OR) turnover time (TT) significantly impacts hospital efficiency, costs, and patient flow.
  • Current TT management often faces challenges in consistency and reproducibility, leading to variability.
  • Optimizing TT is crucial for improving overall surgical throughput and resource utilization.

Purpose of the Study:

  • To identify existing problems in operating room turnover time management.
  • To implement a consistent, reproducible process to reduce average TT and its variability.
  • To evaluate the effectiveness of a redesigned, systems-based approach to OR TT.

Main Methods:

  • Initial observations documented the existing OR turnover process at an academic medical center.
  • A redesigned process focused on a horizontally structured, systems-based approach with three key interventions.
  • Interventions included: consistent OR readiness criteria, parallel processing for patient and room readiness, and enhanced perioperative communication.
  • The redesigned process was implemented in Orthopedic and Vascular Surgery, with comparisons made using independent t-tests.

Main Results:

  • Overall TT reduced by 46.9% (20:48 min) across all surgical specialties (n=237), from 44:23 to 23:25.
  • TT standard deviation decreased by 10:32 min, and the frequency of TT ≥30 min dropped from 72.5% to 11.7% (P < 0.001).
  • In Orthopedics and Vascular Surgery (n=13), mean TT reduced by 39.4% (15:16 min), from 38:51 to 23:35 (P < 0.001).

Conclusions:

  • A systems-based OR redesign focusing on parallel processing and enhanced communication can significantly reduce turnover time.
  • Reductions in mean TT offer substantial opportunities for efficiency, quality improvement, and cost reduction in surgical settings.
  • The implemented interventions demonstrate a reproducible model for optimizing OR workflow and patient throughput.