The Particulars: Anecdotal evidence suggests that less than half of first surgical cases of the day start on time in some operating rooms (ORs) throughout the United States. Starting surgery in a more punctual manner may increase patient and staff satisfaction. It may also reduce the need for overtime pay and could increase revenue via the addition or more cases.

Data Breakdown: In an effort to improve on time starts, a multidisciplinary team at Dartmouth Hitchcock Medical Center tested a redesigned approach to patient preparation workflow. Changes included tasks performed in the surgical clinics, pre-anesthesia testing areas (days before surgery), and preoperative laboratory, radiology, and transportation workflow. Investigators also made workflow changes for surgeons, anesthesia providers, nurses, and technicians on the day of surgery. Implementing these changes—and reminding caregivers of the goals of improving OR start times—increased on-time starts from 53% to 82% during the study. The changes also led to a decrease in delays from 4.0 minutes to 7.2 minutes.

Take Home Pearl: A multidisciplinary team approach to improving OR on-time starts that focuses on patient preparation workflow appears to significantly increase the rate of on-time starts and decrease delay times.