Amanda Akers

6 Tactics for Improving Operating Room Efficiency

The operating room is a hospital’s largest cost center, commonly generating over 50% of a hospital’s revenue. Although a hospital’s primary goal is to care for patients, running efficiently and maintaining comfortable margins are as important for a hospital as they are for a Fortune 500 company. The more efficient the operating room, the more the hospital has the capacity to invest in its staff and keep costs low for its patients.

Efficiency in the OR can also have a significant effect on patient outcomes. The more quickly the surgical team can complete a procedure, the better it is for the patient. First, inefficiency can be frustrating for OR staff, creating a more stressful environment for surgical procedures. Second, depending upon the type of operation, patients undergo varying levels of anesthesia and often suffer some level of blood loss. While the surgical team accounts for these risks, the margins for error grow thinner the longer it takes to complete the operation. An operation that takes significantly longer than planned puts the patient at far greater risk of excessive blood loss and other complications.

improving or efficiency

Numerous indicators can signal to what degree an OR is operating at peak efficiency. Overall case count is the most apparent of of these, as it demonstrates whether the hospital is making the best use of its facility and staff size. If a hospital finds that its case count is falling below the median for facilities of similar size, it should explore whether it can take steps towards improving operating room efficiency.

Six tactics for improving operating room efficiency

  1. Increase On-Time Starts
  2. Evaluating on-time starts involves determining the number of cases that begin exactly at the time they are scheduled. By taking steps to increase on-time starts, a hospital can keep a more rigorous schedule for surgical procedures, thereby multiplying case count. Some factors preventing on-time starts, such as patient behavior, may be outside of the hospital’s control, but timely communication, smart scheduling, and accurate OR preparation can occasion more on-time starts.

  3. Decrease Turnover Time
  4. Reducing the time between surgical cases can also improve case count, as lower turnover time in turn enables on-time starts. Turnover time includes the time it takes to clean up after a procedure and re-set it for the next one. In addition to cleaning and sanitization of the operating room itself, turnover includes accounting for and returning any unused surgical supplies. Minimizing the amount of supplies that must be returned to the CPD/SPD after a procedure can thus aid greatly in decreasing turnover time.

  5. Ensure Preference Card Accuracy
  6. Preference card accuracy has a significant impact on OR efficiency, as it can affect OR turnover time, on-time starts, and procedure length. Clinical staff use preference cards for OR set-up to designate exactly the supplies that are required for a procedure, depending on the preferences of the operating surgeon. Because the preferences of the surgeon and the availability of surgical supplies may change often and without warning, preference cards are at constant risk of inaccuracy if they are not monitored regularly.

    When preference cards are inaccurate, they either list supplies that the OR does not need or lack items that are necessary to the procedure. When they list extraneous items, staff must scan, account for, sometimes sterilize, and return all these supplies to the SPD/CPD after the surgery. This process lengthens OR turnover time, putting on-time starts at risk and wasting the valuable time of clinicians.

    If necessary items are missing, on the other hand, a surgeon must pause mid-procedure. In these cases, the circulating nurse must leave the sterile environment to locate the missing items. This situation is frustrating for everyone in the OR and lengthens the procedure, which is not only expensive and detrimental to OR efficiency but may also endanger the patient. Using the appropriate tools and processes to ensure preference card accuracy is therefore imperative to improving operating room efficiency.

  7. Mandate Proper Scheduling
  8. Poor scheduling can cause numerous problems for the OR, such as conflicting schedules, delayed starts and cancellations, and bottlenecks in the post-anesthesia care unit. These problems are highly detrimental to OR efficiency and the resulting case count. Using appropriate scheduling systems or software tools to manage scheduling can thus help in maintaining an efficient OR.

  9. Streamline Admin Work
  10. Exorbitant administrative work can bog down the OR and cause delays, as well as exacerbating burnout for clinical staff. Using automation to streamline administrative work can thus aid OR efficiency by reducing human error and eliminating tedious work for clinicians. OR scheduling and preference card management both lend themselves well to automation, and using software to manage these processes can directly improve OR efficiency.

  11. Use Trusted Business Techniques
  12. Although the majority of hospitals are non-profit organizations, hospitals are still a type of enterprise, and thus they respond positively to many of the techniques used to run for-profit businesses. Many hospitals have found success in using techniques such as Lean Management and Six Sigma to improve operations. Hospitals can take advantage of these techniques to reduce bureaucracy and busywork, thereby increasing OR efficiency.

    An efficient OR contributes greatly to a financially stable hospital. By improving operating room efficiency, hospitals can increase their overall case count and thereby generate more revenue. Better margins, in turn, improve the hospital’s bottom line and positively affect both clinicians and patients.