A Successful Organized Effort to Improve Operating Room First-Case Starts in a Tertiary Academic Medical Center. Issue 2 (February 2021)

• Record Type: Journal Article
• Authors: Chua, Melissa M. J.; Lewis, Keith; Huang, Yi-An; Fingliss, Mary; Farber, Alik
• Is Part Of: American surgeon. Volume 87:Issue 2(2021)
• Page Start: 259
• Page End: 265
• Publication Date: 2021-02
• Subjects: OR efficiency -- on-time first-start -- quality improvement; Surgery -- Periodicals; Surgery -- United States -- Periodicals; 617.0973
• DOI: 10.1177/0003134820951430
• Languages: English
• ISSNs: 0003-1348

Abstract

Background: Operating room (OR) inefficiency drives up cost, decreases revenue, and leads to surgeon, staff, and patient dissatisfaction. Given a low mean first-case start rate in our tertiary academic medical center, we developed a process to improve first-case start rates in an effort to increase OR efficiency. Methods: A working group of the OR Executive Committee was constituted to develop and implement a multistep operational plan. This plan was predicated on a sensible staggered start framework, coordination of stakeholder responsibilities, a visual preoperative Stop/Go checklist tool, real-time measurement, and feedback. Results: Within 11 days of implementation, 95% of first-start OR cases were tracked to start on time. Throughout the observation period (May 2015-July 2016), the goal of a daily mean 80% on-time start rate was either met or exceeded. Conclusions: Implementation of an organized collaborative effort led to dramatic improvements in first OR case on-time rates. Such improvement in OR utilization may lead to an increase in staff and patient satisfaction and cost reduction.