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Maximizing Efficiency: A Quality Improvement Project to Improve Inpatient Flow to the Operating Room
Amber M Franz1, Christina M Street1, Colin D Crook2
1From the Department of Anesthesiology and Pain Medicine, Seattle Children's Hospital, University of Washington, Seattle, Wash.
Pediatric Quality & Safety
|July 31, 2026
Summary
Improving operating room (OR) efficiency for pediatric inpatients undergoing surgery, this study reduced patient transition times by 9.3%. Enhanced communication and process improvements streamlined preoperative readiness, minimizing costly OR delays.
Area of Science:
- Healthcare Operations
- Quality Improvement Science
- Pediatric Surgery
Background:
- Annually, 500,000 pediatric inpatients undergo surgery.
- Lengthy and unreliable patient transitions to preoperative zones cause significant operating room (OR) delays.
- Improving preoperative efficiency is crucial for academic pediatric hospitals.
Purpose of the Study:
- To enhance preoperative efficiency by 10% for nonintensive care unit inpatients undergoing nonemergent surgery.
- To reduce the time from OR call to completion of preoperative nursing tasks.
- To improve patient flow and communication within the perioperative microsystem.
Main Methods:
- Utilized the Institute for Healthcare Improvement (IHI) model framework.
- Implemented multiple Plan-Do-Study-Act (PDSA) cycles to refine processes.
- Employed statistical process control (SPC) charts to monitor key performance indicators.
Main Results:
- Achieved a 9.3% improvement in mean transition time (48.2 to 43.7 minutes).
- Demonstrated a sustained reduction in process variability post-intervention.
- SPC analysis showed a downward shift in the process centerline, indicating sustained improvement.
Conclusions:
- PDSA cycles targeting inpatient-to-OR readiness significantly improved patient flow.
- Enhanced interdisciplinary communication and awareness of preoperative tasks were key outcomes.
- Further research is needed to validate these interventions in other healthcare settings.
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