Improving operating room productivity and efficiency - are there any simple strategies?

Rising costs and diminishing reimbursements require hospitals to continually find ways to improve efficiency and productivity. The operating room (OR) is a costintensive environment requiring efficient and effective management. The power of performance of the OR is crucially dependent on the cooperation of the surgical, anaesthesia, nursing and allied health professionals involved. Dr O’Donnell and colleagues from the Department of Anaesthesia, Cork University Hospital, Ireland studied the effects of a number of work practice changes, including modification of patient processing and additional manpower, on non-operating time, number of cases performed and patient cancellations in a dedicated soft-tissue trauma surgical unit [1]. Work practice changes included a transition from sequential patient processing to parallel patient processing and increased use of regional anaesthesia, when feasible. The study findings were disappointing because, despite additional anaesthesia input and limited work practice changes, there was no increased operating room capacity or reduction in non-operative time. A remarkable average 2 hours of operating room time was lost daily due to avoidable delays. Not unexpectedly, the expansion of regional anaesthesia use for upper extremity surgery reduced the duration of recovery room utilization and stay. Why did the context-specific work practice changes adopted in this study design fail so spectacularly to achieve the desired primary and secondary patient outcomes? Study design and methodology limitations included an anaesthesia rather than a surgeon team DOI: http://dx.doi.org/10.21454/rjaic.7518.242.cnn