Process improvement strategy to implement an outpatient surgery center efficiency model in an academic inpatient setting

By utilizing process improvement methodology, we aim to: 1) create an ambulatory surgical efficiency model (SEM) confined to an inpatient setting, and 2) reduce patient wait time and improve patient flow within the operating room. A prospective cohort of all otolaryngology cases performed from May 2016 to October 2017 at a tertiary, academic, pediatric hospital. Intraoperative timestamps were collected to determine turnover times. Time to procedure was collected from clinic visit to the day of operation. A total of 5955 patients were enrolled. 3393 cases were performed prior to the implementation of SEM and 2562 after. Of the 2562 cases, 819 were deemed appropriate for the SEM. Prior to the SEM, the average number of working days between the clinic visit and operating room (WD) was 31.1 days (95% CI 30.7–31.4). After the SEM, the WD for non-SEM cases was 30.0 days (95% CI 29.7–30.2), and the WD for SEM cases was 14.4 days (95% CI 14.2–14.6). The average turnover time was significantly less for SEM cases at 11.4 min (95% CI 10.7–12.2) vs. non-SEM cases at 24.4 min (95% CI 23.9–25.0) (p