Optimizing the OR: a bottom-up approach.

Efficiency in the operating room (OR) has important implications on finances, access, and patient and staff satisfaction. UC Davis Medical Center (UCDMC) launched an initiative to increase OR efficiency by using multidisciplinary staff-based teams. The initiative freed up 5,500 annual hours-about 1 hr per operating room per day-in the OR by improving the percentage of first case on-time starts, reducing OR turnover times, improving scheduling predictability and reducing the number of controllable cancellations. Importantly, the process also engrained a continuous quality improvement mentality into the medical center's culture.