It's Showtime! Two interventions reduce operating room turnover time by 20% in an academic medical center.

Abstract

Operating room turnover time is a major source of perioperative inefficiency affecting patient care, staff satisfaction, and institutional revenue. A multidisciplinary, collaborative approach to turnover time reduction is required to improve perioperative quality. Surgeons, anesthesiologists, nurses, and perioperative leadership collaborated to develop 2 efficiency interventions. The "Showtime" initiative established a service-specific set-time for a surgical and anesthesia representative to meet in preoperative holding for the operating room's next patient. The "Intentional Rounding" initiative included the charge nurse performing room-to-room morning rounds to proactively identify and mitigate turnover time efficiency issues for the day. These interventions were initiated across the neurosurgery, orthopedics, otolaryngology, and transplant/hepatobiliary service lines within an academic medical center. Implementation of the Showtime and Intentional Rounding initiatives resulted in an average reduction in turnover time of 10.5 minutes (20%) across all service lines. Improvement was noted across each service line, with improvement times ranging from 7 to 22 minutes (17% to 32% improvement, respectively), as well as the ability to sustain higher monthly case volumes. An expected 440 hours of turnover time was recovered during the study period, associated with an estimated savings of $361,419 in direct "empty operating room" costs recovered over the 20-month study period (around $18,000/mo). Two multidisciplinary perioperative interventions focused on improving operating room turnover time efficiency resulted in a systemwide 20% reduction in average turnover time at an academic medical center, with estimated cost savings of more than $18,000 per month. These interventions are sustainable, low resource-intensive, and reproducible across multiple service lines.