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April 2003

Efficiency of the Operating Room vs the Short Procedure Room: Squeezing the Balloon

Arch Otolaryngol Head Neck Surg. 2003;129(4):427-428. doi:10.1001/archotol.129.4.427

ATTEMPTING TO improve operating room (OR) efficiency can be likened to squeezing a balloon into a small plastic bag: putting pressure on one area will merely shift the air in the balloon to another area. Similarly, attempting to improve OR efficiency may result in unanticipated problems elsewhere in the system. For example, some surgeons may require all patients having surgery that day to arrive at 6:30 AM—which will avoid the problem of waiting for a late patient or one whose surgery will be delayed because of failure to adhere to NPO guidelines—but this solution comes at the expense of a congested preoperative waiting area and some unhappy, hungry patients. In the article by Brenn et al1 in this issue of the ARCHIVES, they present a retrospective study of efficiency of procedures performed in a short procedure room (SPR) with a circulator only compared with procedures performed in a conventional OR (circulator plus surgical technician). In this study, efficiency is defined as a shorter total operative time per procedure. This private practice model is shown to be effective in cutting OR time by as much as 5 minutes per case, demonstrating that tertiary care centers can potentially become more cost-effective by eliminating a surgical technician in specially chosen uncomplicated cases (ie, tonsillectomy, adenoidectomy, or myringotomy and tubes). This model may be used by tertiary care centers to increase efficiency and to attempt to streamline costs.