210 - Reducing Turnover Time and Improving First Case On-Time Starts at Kaiser Oakland

Description: In 2025, US healthcare spending is projected to reach $5.3 trillion, representing nearly 20% of the nation's GDP. This figure is an increase from the 17.5% share in 2014. Kaiser Oakland Medical Center operates 23 operating rooms (ORs) across 19 specialties and is experiencing year-over-year growth. Efficient OR management is critical for both reducing costs and enhancing patient care. With the average cost per minute of OR time over $115, this study aims to reduce turnover time (TOT) and increase first case on-time starts (FCOTS) to improve productivity, cost containment, and patient satisfaction.

This project focuses on optimizing workflow and efficiency through standardization to uncover inefficiencies and bottlenecks that increase turnover time; improving staff utilization while maintaining a patient safety climate: assessing how staffing patterns, clear roles and responsibilities and training affect results and uncover opportunity for better coordination; and fostering teamwork to streamline the turnover process by measuring how a culture of accountability and teamwork culture impact TOT/FCOTS and the overall flow of the OR. By reducing TOT and improving FCOTS, we not only anticipate creating opportunity to reduce cost of delays in the OR, but also improved patient safety, infection control, and patient-centered outcomes. A well-managed OR is expected to lead to fewer postoperative complications, greater patient satisfaction, and better overall surgical outcomes. Additionally, the project aims to promote a culture of accountability and teamwork, encouraging staff to take pride in their work while recognizing the importance of cost containment and operational efficiency.

The study's goals include standardizing the turnover process to ensure that patients are transitioned between cases efficiently. Key metrics such as TOT, FCOTS, infection rates, and care experience will be tracked and analyzed to ensure the best outcomes. A strong emphasis is placed on improving communication and collaboration among the perioperative team to foster a cohesive environment and reduce delays.

Keywords: turnover time, first case on-time starts, operating room efficiency, patient safety, infection control, staff utilization, teamwork, cost containment.