Reduction in Operating Room Turn Times

Project Focus

The concern was that the volume of scheduled operations was more than the Operating Rooms could handle. Our goal was to reduce Operating Room turnaround times, effectively boosting available room time to handle demand.

Data

Operating Room start times were dismal. Average delays were around 12 min. In a unique move, the room set-up process was videotaped and reviewed. This revealed that 8 min could be saved, only by removing redundancies in the work process. We believed that with minor impact, and some training, we could save 20 min between each case. This may not sound like a great deal, but when we calculated daily savings over the current system, it came to a whopping 500 min each day. This is the equivalent of freeing up an entire Operating Room. It costs 5 million dollars to build an Operating Room, and another $1,000 an hour to run it. Our study had revealed a very significant cost saving.

Leadership

Our team was the following: OR representative, Administrative representative, PACU representative, Bed Assignment, and Lean Sigma representative

Timeline

Out Team determined we would need 2 months to conclude study.

Scaling

If we could find any savings in one room, it could be scaled to every OR in the system.

After our analysis and conclusions were complete, the recommendations were presented. Everyone agreed that the recommendations, if acted upon, would save the system millions of dollars, with veiy little upfront cost. Success would be highly likely. But the result was not success. No one was willing to hold surgeons accountable for on-time starts. There is little will within many hospitals to fight this kind of fight, and in this particular case, the project was shelved and put on hold indefinitely.

The lesson here is that accountability is key to managing changes in health care. There is significant reluctance, however, to hold senior physicians to account, or to demand that they change their schedules, lifestyles, expectations, or habits in any way. To do so is very uncomfortable and takes a great deal of effort. Ultimately, it may take a reminder that accountability for patient care rests on those physician’s shoulders, and that sometimes a change of habit or a coveted tee-off time is simply the right thing to do. Again, we must keep the patient at the center of our healthcare system.