The Ongoing Battle of Operating Room Turnover Times

Abstract

Prolonged operating room (OR) turnover times negatively affect surgical throughput, staff satisfaction, and financial performance. Literature estimates OR time to cost up to $150 per minute, with inefficiencies contributing substantially to operational waste. The purpose of this quality improvement project was to decrease average OR turnover time from 30 minutes to 25 minutes in an acute-care facility. Guided by Lean Six Sigma principles and informed by a comprehensive microsystem assessment, a lean-based process redesign bundle was proposed. Interventions within the bundle included standardization of case carts and surgical trays, implementation of a revised turnover checklist, parallel task assignment, defined task ownership, and use of real-time visual cues. Literature demonstrates that bundled Lean interventions can reduce turnover time by up to 26 minutes while maintaining patient safety. Outcome measures included mean turnover time, on-time case starts, and case volume. Anticipated outcomes include improved workflow efficiency, increased capacity, reduced non-value-added time, and enhanced staff engagement. This project demonstrates how a Clinical Nurse Leader-driven, Lean-guided approach can address operational inefficiencies while maintaining patient safety.