KEY POINTS

1. Reorganizing the governance structure of the OR to consolidate control and authority into one position, such as the OR medical director, has many advantages in making the OR function at an optimal level.
2. Improvement in the OR scheduling process may lead to the biggest gains in OR efficiency. Block time scheduling allows better predictability and satisfaction for OR personnel.
3. On-time OR starts, surgical case performance benchmarks, and room turnover are all critical elements in making an OR run efficiently.
4. Traditional OR utilization assessments may not reflect how well an OR is working. Newer methods that focus on OR productivity are increasingly being used to determine allocation of OR resources.
5. Managing the daily surgical schedule requires careful planning, as well as frequent re-evaluation, to deal with the variability in case times, add-ons, and cancellations.
6. The OR director must create a professional environment in the OR and not allow disruptive behavior patterns to exist.
7. A detailed OR information system is essential in tracking OR activity and creating reports for assessment and improvement projects. OR cost accounting is essential to the OR director in guiding decisions for resource application.