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Utilizing a 3D Printed Laparoscopic Nissen Fundoplication Model to Shorten a Resident's Learning Curve
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Improving Operating Room Efficiency: First Case On-Time Start Project.

Laura Phieffer, Jennifer L Hefner, Armin Rahmanian

    Journal for Healthcare Quality : Official Publication of the National Association for Healthcare Quality
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    Summary
    This summary is machine-generated.

    Improving operating room (OR) efficiency is crucial. Implementing Six Sigma tools significantly boosted first case on-time starts (FCOS) from 49% to a peak of 92%, demonstrating sustained gains in OR scheduling performance.

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    Area of Science:

    • Healthcare Management
    • Process Improvement
    • Surgical Operations

    Background:

    • Operating room (OR) efficiency is critical due to high costs.
    • First case on-time start (FCOS) is a key indicator of daily OR schedule efficiency.
    • Initial FCOS rates at a large academic medical center were only 49% in October 2011.

    Purpose of the Study:

    • To improve the efficiency of operating room scheduling.
    • To increase the rate of first case on-time starts (FCOS).
    • To identify and address factors contributing to OR delays.

    Main Methods:

    • An interdisciplinary Operating Room Committee applied Six Sigma tools.
    • Key steps included problem mapping and process improvements in preoperative readiness.
    • Enhancements in informatics support and continuous data feedback were implemented.

    Main Results:

    • First case on-time starts (FCOS) peaked at 92% by June 2013, remaining significantly above the baseline 49% (p = .000).
    • Delay minutes also significantly decreased throughout the study period (p = .000).
    • Common causes of delays in 2013 included patient, surgeon, facility, and anesthesia factors.

    Conclusions:

    • Sustained improvement in FCOS is linked to consistent metric tracking and process improvement resources.
    • Transparency of data and embedded resources are vital for program success and sustainability.
    • Addressing identified delay owners is key to maintaining OR efficiency.