Reducing non-operative time: methods and impact on operating room economics

Improving operating room throughput is a perennial objective, but only incremental gains have been reported in the past. Recently, however, in situations characterised by short operative times, several teams have reported substantial increases in throughput, by addressing non-operative time rather than just its component, turnover time. The methods employed fall into five categories. Reviewing published results, we deduce the potential impact of each category on the reduction of non-operative time. Next, we estimate the reduction in non-operative time that must be achieved reliably to add cases to a 'full' operating room schedule, given a variety of operative times. Finally, we calculate potential incremental margin contributions of several of the reviewed perioperative systems, when implemented in a typical US hospital. We conclude that the benefits of introducing the methods outweigh their costs, but caution that hospitals need to increase their caseload of short procedures to realise these benefits.