Improving Operating Room Efficiency
Purpose of Review
Operating rooms are critical financial centers for hospital systems, with surgical care representing about a third of all health care spending. However, not all of the costs are appropriate or necessary, as there are sometimes significant inefficiencies in how operating rooms are utilized.
Recent innovations utilizing patient-centered data, systems principles from manufacturing industries, and enhanced communication processes have made significant improvements in improving operating room efficiency.
By focusing on improving communication, standardizing processes, and embracing a learning health system with innovations, significant improvements in operating room efficiency can be seen to improve outcomes and costs for the health system and patient.
KeywordsOperating room efficiency Operating room costs Six sigma Lean Cost efficiency
Compliance with Ethical Standards
Conflict of Interest
Daniel J. Lee, James Ding, and Thomas J. Guzzo each declare no potential conflicts of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: •• Of major importance
- 1.Hall MJ, Schwartzman A, Zhang J, Liu X. Ambulatory surgery data from hospitals and ambulatory surgery centers: United States. Natl Health Stat Report. 2010;2017:1–15.Google Scholar
- 2.NQF-Endorsed Measures for Surgical Procedures, 2015–2017. Department of Health and Human Services. National Quality Forum. Accessed on January 3, 2019. https://www.qualityforum.org/Publications/2017/04/Surgery_2015-2017_Final_Report.aspx.
- 4.McDermott KW (IBM Watson Health), Freeman WJ (AHRQ), Elixhauser A (AHRQ). Overview of Operating Room Procedures During Inpatient Stays in U.S. Hospitals, 2014. HCUP Statistical Brief #233. December 2017. Agency for Healthcare Research and Quality, Rockville, MD. www.hcupus.ahrq.gov/reports/statbriefs/sb233-Operating-Room-Procedures-United-States-2014.pdf.
- 6.Cerfolio RJ, Ferrari-Light D, Perry N, et al. Improving operating room turnover time in a New York City Academic Hospital via Lean. Ann Thorac Surg 2019.Google Scholar
- 14.Jayne D, Pigazzi A, Marshall H, Croft J, Corrigan N, Copeland J, et al. Effect of robotic-assisted vs conventional laparoscopic surgery on risk of conversion to open laparotomy among patients undergoing resection for rectal Cancer: the ROLARR randomized clinical trial. JAMA. 2017;318:1569–80.CrossRefGoogle Scholar
- 23.•• Argo JL, Vick CC, Graham LA, Itani KM, Bishop MJ, Hawn MT. Elective surgical case cancellation in the Veterans Health Administration system: identifying areas for improvement. Am J Surg. 2009;198:600–6 Example of a data driven implementation for quality improvement within the Veterans Health Administration system.CrossRefGoogle Scholar
- 31.Luo L, Zhang F, Yao Y, Gong R, Fu M, Xiao J. Machine learning for identification of surgeries with high risks of cancellation. Health Informatics J 2018:1460458218813602.Google Scholar
- 32.The Health Literacy of America’s Adults. National Assessment of Adult Literacy. U.S. Department of Education. https://nces.ed.gov/pubs2006/2006483.pdf. Accessed 3/15/2017.
- 33.Robinson JR, Davis SE, Cronin RM, Jackson GP. Use of a patient portal during hospital admissions to surgical services. AMIA Ann Symp Proc. 2016;2016:1967–76.Google Scholar
- 56.Fairley M, Scheinker D, Brandeau ML. Improving the efficiency of the operating room environment with an optimization and machine learning model. Health Care Manag Sci 2018.Google Scholar
- 64.Farrokhi F, Gunther M, Williams B, Blackmore C. Application of lean methodology for improved quality and efficiency in operating room instrument availability. J Healthc Qual. 2013;00:1–10.Google Scholar
- 65.Lunardini D, Arington R, Canacari EG, Gamboa K, Wagner K, McGuire KJ. Lean principles to optimize instrument utilization for spine surgery in an academic medical center: an opportunity to standardize, cut costs, and build a culture of improvement. Spine (Phila Pa 1976). 2014;39:1714–7.CrossRefGoogle Scholar
- 74.Basto J, Chahal R, Riedel B. Time-driven activity-based costing to model the utility of parallel induction redesign in high-turnover operating lists. Healthc (Amst) 2019.Google Scholar