OBJECTIVES : Inefficient operating rooms (OR) can adversely impact hospital economics. An OR Optimization Program was implemented in an Italian hospital to enhance OR processes in spine surgeries, while maintaining patient outcomes. This retrospective observational study seeks to estimate time-related efficiency gains after implementation of this program.

METHODS : Patients aged 18+ who underwent elective spine surgery (primary or revision) for degenerative or deformity indications in Galeazzi Orthopedics Institute were included. OR procedure times were collected through paper questionnaires before and after program implementation by hospital staff. Outcomes included start time of OR set-up for the 1^st patient of the day, entrance time in the OR for the 1^st patient of the day, OR cleaning time and OR turnaround time (between skin closure and skin incision of the next patient). Outcomes were analyzed descriptively comparing pre and post OR Optimization Program. Exploratory statistical t-tests were conducted to compare groups.

RESULTS : 79 patients were included for a total of 101 procedures. 22 patients had multiple procedures on the same day. Compared to before the program, earlier starting time for OR set-up for the 1^st patient of the day was observed (7h43 vs 7h54; p<0.01). The 1^st patient also entered the OR earlier (8h01 vs 8h16; p<0.05). Mean OR cleaning time was reduced from 18.6 to 13.9 minutes (p<0.01). Patients undergoing multiple consecutive procedures had shorter mean OR turnaround time (56.2 vs 68.6 minutes; p=0.06). The mean OR turnaround time for all procedures did not differ (77 pre vs 79 minutes post; p=0.6).

CONCLUSIONS : This exploratory study suggests that an OR Optimization Program can improve efficiency and has the potential, by saving OR time, to save hospital resources in terms of costs. Patient outcomes were not studied, but should be included in future work to ensure that efficiency gains are attained while maintaining or improving patient outcomes.