D153. Improving Operating Room Efficiency Through Reducing First Start Delays in an Academic Center

Abstract

PURPOSE: Delays in operating room (OR) first case start times can cause additional costs for hospitals, healthcare team frustration and delay patient care. Here, we present our findings on a novel process improvement strategy and its effects on improving first case start times at an academic medical center. METHODS: First case in room start times were recorded for operating rooms at an academic medical center. Three interventions - automatic pre-operative orders, dot phrases to permit re-creation of unavailable consent forms, and improved H&P linking to the surgical encounter - were implemented to target documentation-related delays. Monthly percentages of first case on-time starts (FCOTS) and time saved were compared to the “pre-intervention” time period. Total cost savings from reduced operating room time was also estimated. RESULTS: During the first 3-months after implementation of the interventions, the percentage of FCOTS improved from an average of 36.7% to 52.7%. Total time savings across all operating rooms over the same time period was found to be 55.63 hours, which is estimated to have saved a total of $121,834.52 over the three-month interventional period. CONCLUSION: By implementing multiple quality improvement interventions, delays to first start in room OR cases can be meaningfully reduced. In high volume surgical centers and hospitals, these incremental changes can lead to substantial cost savings in both direct and indirect costs. Understanding the root causes of OR delays and designing quality improvement protocols to target those root causes can ultimately be a significant driver to reduce healthcare costs.