Targeting operating room inefficiencies in the complex management of vision-threatening diseases in children

Objective: To review the effect of interventions designed to decrease turnover time in infants and children (median age, 2.6 years; range, 1 month to 10 years) who required examinations under anesthesia. Methods: Five efficiency interventions (3 anesthesia providers for 2 rooms, digital remote communication, change in patient scheduling, standardization of case order, and streamlining administration of preoperative medications) were implemented during a 4 1/2-year period from January 2003 to July 2007. Using data from our in-house operating room information system, we analyzed turnover times (time it took 1 patient to leave the operating room and the next to enter). Results: The mean turnover times decreased from 12.1 minutes to 3.8 minutes. The 90th percentile of longest turnover times decreased from 14.5 minutes in 2003 to 5.8 minutes in 2007, despite a progressive increase in the number of cases per day. Conclusion: Caring for children who require extensive examinations under anesthesia can be efficiently achieved in nonpediatric environments.