title: Operating room efficiency improvement after implementation of a postoperative team assessment.
abstract: BACKGROUND
  Operating room time is highly resource intensive, and delays can be a source of lost revenue and surgeon frustration. Methods to decrease these delays are important not only for patient care, but to maximize operating room resource utilization. The purpose of this study was to determine the root cause of operating room delays in a standardized manner to help improve overall operating room efficiency.
  
  
  METHODS
  We performed a single-center prospective observational study analyzing operating room utilization and efficiency after implementing an executive-driven standardized postoperative team debriefing system from January 2010 to December 2010.
  
  
  RESULTS
  A total of 11,342 procedures were performed over the 1-y study period (elective 86%, urgent 11%, and emergent 3%), with 1.3 million min of operating room time, 865,864 min of surgeon operative time (62.5%), and 162,958 min of anesthesia time (11.8%). Overall, the average operating room delay was 18 min and varied greatly based on the surgical specialty. The longest delays were due to need for radiology (40 min); other significant delays were due to supply issues (22.7 min), surgeon issues (18 min), nursing issues (14 min), and room turnover (14 min). Over the 1-y period, there was a decrease in mean delay duration, averaging a decrease in delay of 0.147 min/mo with an overall 9% decrease in the mean delay times. With regard to overall operating room utilization, there was a 39% decrease in overall un-utilized available OR time that was due to delays, improving efficiency by 2334 min (212 min/mo). During this study interval no sentinel events occurred in the operating room.
  
  
  CONCLUSIONS
  A standardized postoperative debrief tracking system is highly beneficial in identifying and reducing overall operative delays and improving operating room utilization.
authors.affiliation: Department of Surgery, Madigan Healthcare System, Tacoma, WA98431, USA. reesporta@yahoo.com
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Porta
authors.forename: Andrew
authors.initials: A
authors.lastname: Foster
authors.forename: Marlin W
authors.initials: MW
authors.lastname: Causey
authors.forename: Patricia
authors.initials: P
authors.lastname: Cordier
authors.forename: Roger
authors.initials: R
authors.lastname: Ozbirn
authors.forename: Stephen
authors.initials: S
authors.lastname: Bolt
authors.forename: Dennis
authors.initials: D
authors.lastname: Allison
authors.forename: Robert
authors.initials: R
authors.lastname: Rush
mesh_terms: D004526:Efficiency; D006801:Humans; D009873:Operating Rooms; D010348:Patient Care Team; D061214:Patient Safety; D011184:Postoperative Period; D011446:Prospective Studies; D013997:Time Factors