Improving Operating Room Turnover Time in a New York City Academic Hospital via Lean

Area of Science:

• Healthcare Management
• Process Improvement
• Surgical Operations

Background:

• Prolonged operating room (OR) turnover times negatively impact patient and employee satisfaction and overall healthcare value.
• Inefficiencies in OR turnover contribute to increased costs and reduced throughput.

Purpose of the Study:

• To evaluate the effectiveness of Lean and value stream mapping in reducing operating room turnover time.
• To assess the impact of a piloted Performance Improvement Team (PIT Crew) on OR efficiency and cost-effectiveness.

Main Methods:

• Applied Lean and value stream mapping to three OR teams at an academic health center.
• Piloted a Performance Improvement Team (PIT Crew) to implement identified process changes.
• Analyzed 35 pilot turnovers against historic matched controls.

Main Results:

• Eliminated 10% of non-value-added OR turnover steps and made 25% of sequential steps synchronous.
• Reduced median OR turnover time from 37 minutes to 14 minutes (p < 0.0001).
• Achieved an estimated daily return on investment of $19,500 with a daily cost of $1,298 for the PIT Crew.

Conclusions:

• Lean and value stream mapping effectively identify and eliminate non-value-added steps in OR turnover, enhancing efficiency.
• Modifying institutional rules and policies, alongside cultural shifts, leads to substantial improvements in turnover time.
• The PIT Crew model demonstrates profitability, though scalability, sustainability, and broader cultural impact require further investigation.