Improving operating room efficiency via an interprofessional approach

Jeffrey S Bender; Teodora O Nicolescu; Susan B Hollingsworth; Krystal Murer; Kristina R Wallace; William J Ertl

doi:10.1016/j.amjsurg.2014.12.007

Improving operating room efficiency via an interprofessional approach

Am J Surg. 2015 Mar;209(3):447-50. doi: 10.1016/j.amjsurg.2014.12.007. Epub 2014 Dec 20.

Authors

Jeffrey S Bender¹, Teodora O Nicolescu², Susan B Hollingsworth³, Krystal Murer³, Kristina R Wallace³, William J Ertl⁴

Affiliations

¹ Department of Surgery, University of Oklahoma College of Medicine, Oklahoma City, OK, USA. Electronic address: jeffrey-bender@ouhsc.edu.
² Department of Anesthesiology, University of Oklahoma College of Medicine, Oklahoma City, OK, USA.
³ OU Medical Center, Oklahoma City, OK, USA.
⁴ Department of Orthopedic Surgery, University of Oklahoma College of Medicine, Oklahoma City, OK, USA.

PMID: 25770394
DOI: 10.1016/j.amjsurg.2014.12.007

Abstract

Background: Third-party payer reimbursements will likely continue to decrease. Therefore, it is imperative for operating rooms (ORs), often a hospital's largest revenue source, to improve efficiency. We report the outcome after 3 years of a lean, Six Sigma program to improve OR utilization.

Methods: In January 2011, our hospital system instituted a facility-wide approach to address the problem of OR efficiency. Interprofessional teams were formed to examine all aspects of OR use. An OR Governance Committee consisting of Department Chairs, nursing and senior administration oversaw the project.

Results: Outpatients' readiness on time for surgery increased from 59% to 95%, while first case on-time starts improved from 32% to 73%. Block utilization went from 68% to 74% and actual room utilization improved from 56% to 68%. The number of cases increased by 9%. Overtime went from 7% of total to 4%, so personnel costs decreased 14% despite 26% more employees. There was a reduction in annual voluntary OR staff turnover from 28% to 11%. Revenues increased more than 10% annually.

Conclusion: A concerted effort to optimize OR performance resulted in marked improvements in access, overall case efficiency, staff satisfaction, and financial performance.

Keywords: Efficiency; Interprofessional; Operating room; Performance; Six Sigma; Utilization.

MeSH terms

Efficiency*
Follow-Up Studies
Humans
Interprofessional Relations*
Operating Rooms / organization & administration*
Retrospective Studies