Epstein RH, Dexter F, Diez C, Fahy BG. Elective surgery growth at Florida hospitals accrues mostly from surgeons averaging 2 or fewer cases per week: a retrospective cohort study. Journal of Clinical Anesthesia 78:110649, 2022

Kaddoum R, Tarraf S, Shebbo F, Bou Ali A, Karam C, Abi Shadid C, Bouez J, Aouad MT. Reduction of nonoperative time using the induction room, parallel processing, and sugammadex: a randomized clinical trial. Anesthesia & Analgesia 135:406-413, 2022

Kamande S, Sarpong K, Murray J, Ajayi A, Dowlati E, Nair MN. Turnover time between elective operative cases: does the witching hour exist for the operating room? World Journal of Surgery 46:2939-2945, 2022

Riveros Perez E, Kerko R, Lever N, White A, Kahf S, Avella-Molano B. Operating room relay strategy for turnover time improvement: a quality improvement project. BMJ Open Quality 11:e001957, 2022

Sarpong K, Kamande S, Murray J, Wiley A, Bhatnagar A, Dowlati E, Nair MN. Consecutive surgeon and anesthesia team improve turnover time in the operating room. Journal of Medical Systems 46:16, 2022

Stucky CH, De Jong MJ, Li Y. Military surgical team performance: the impact of familiarity, team size, and nurse anesthesia students. Journal of PeriAnesthesia Nursing 37:86-93, 2022

Witmer HDD, Dhiman A, Jones AD, Laffan AM, Adelman D, Turaga KK. A systematic review of operative team familiarity on metrics of efficiency, patient outcomes, cost, and team satisfaction. Annals of Surgery 276:e674-e681, 2022


Athanasiadis DI, Monfared S, Whiteside J, Banerjee A, Keller D, Butler A, Stefanidis D. What delays your case start? Exploring operating room inefficiencies. Surgical Endoscopy 35:2709-2714, 2021

Bathish MA, McLaughlin M, Kleiner C, Talsma A. The effect of RN circulator-scrub person dyad consistency on total OR time and turnover time. AORN Journal 113:276-284, 2021

Chernov M, Vick A, Ramachandran S, Reddy S, Leyvi G, Delphin E. The impact of a teaching staff availability on educational process and OR efficiency in academic hospital. Perioperative Care and Operating Room Management 25:100218, 2021

Epstein RH, Dexter F, Mojica JJ, Schwenk ES. Briefest time to perform a series of preoperative nerve blocks in multiple patients: a simulation study. Cureus 13:e16251, 2021  

Joos C, Bertheau S, Hauptvogel T, Auhuber T, Taube C, Bauer M, Schuster M. Case delay in the OR morning start in hospitals of different size and academic status: results from a German multicenter study to identify incidence and causes of delayed anesthesia ready time. Anaesthesist 70:23-29, 2021

Kane WJ, Shilling AM, Schroen AT. A surgeon badge or text message sign-in intervention improves operating room start efficiency. Journal of Surgical Research 264:129-137, 2021

Mazda Y, Peacock S, Wolfstadt J, Matelski J, Chan V, Gleicher YJ. Developing a business case for a regional anesthesia block room: up with efficiency, down with costs. Regional Anesthesia and Pain Medicine 46:986-991, 2021

Morel SD, Gomez NAG. Improving on-time first case starts: an integrative review and quality improvement project plan. Journal of PeriAnesthesia Nursing 36:717-723, 2021

Tsironis LK, Dimitriadis SG, Kehris E. Monitoring operating room performance with control charts: findings from a Greek public hospital. International Journal for Quality in Health Care 33:mzaa167, 2021

Vannucci A, Riordan IR, Prifti K, Sebastiani A, Helsten DL, Lander DP, Kallogjeri D, Cavallone L. Prolonged time to extubation after general anaesthesia is associated with early escalation of care: a retrospective observational study. European Journal of Anaesthesiology 38:494-504, 2021

Wallace L, Muir M, Romano L, Wyllie T, Gyomber D, Hodgson R. Assessing operating theatre efficiency: a prospective cohort study to identify intervention targets to improve efficiency. ANZ Journal of Surgery 91:2382-2388, 2021

Wong T, Zhang EJ, Elhajj AJ, Rizzo DM, Sexton KA, Pandit JJ, Tsai MH. The power law in operating room management. Journal of Medical Systems 45:92, 2021


Chapman WC Jr, Luo X, Doyle M, Khan A, Chapman WC, Kangrga I, Martin J Jr, Wellen J. Time is money: can punctuality decrease operating room cost? Journal of the American College of Surgeons 230:182-189.e4, 2020

Cohen TN, Anger JT, Shamash K, Cohen KA, Nasseri Y, Francis SE, Fimpler M, Avenido R, Gewertz BL, Shouhed D. Discovering the barriers to efficient robotic operating room turnover time: perceptions vs. reality. Journal of Robotic Surgery 14:717-724, 2020

Dexter F, Epstein RH, Penning DH. Late first-case of the day starts do not cause greater minutes of over-utilized time at an endoscopy suite with 8-hour workdays and late running rooms. A historical cohort study. Journal of Clinical Anesthesia 59:18-25, 2020  

El-Boghdadly K, Nair G, Pawa A, Onwochei DN. Impact of parallel processing of regional anesthesia with block rooms on resource utilization and clinical outcomes: a systematic review and meta-analysis. Regional Anesthesia and Pain Medicine 45:720-726, 2020

Ellis DB, Santoro J, Spracklin D, Kurzweil V, Sylvia S, Fagenholz P, Agarwala A. Improving and maintaining on-time start times for nonelective cases in a major academic medical center. Joint Commission Journal on Quality and Patient Safety 46:81-86, 2020

Epstein RH, Dexter F, Cajigas I, Mahavadi AK, Shah AH, Abitbol N, Komotar RJ. Prolonged tracheal extubation time after glioma surgery was associated with lack of familiarity between the anesthesia provider and the operating neurosurgeon. A retrospective, observational study. Journal of Clinical Anesthesia 60:118-124, 2020

Hicks KB, Glaser K, Scott C, Sparks D, McHenry CR. Enumerating the causes and burden of first case operating room delays. The American Journal of Surgery 219:486-489, 2020

Jreije K, Sachdeva S, Cull M, Diaz G, Romero J, Schweitzer J. Rewarding on time start times in operating rooms improves efficiency. The American Surgeon 86:1391-1395, 2020

Lee E, Daugherty J, Selga JT, Schmidt U. Improving surgical start times by improving wayfinding. Journal of PeriAnesthesia Nursing 35:17-21, 2020

Li H, Su Z, Ma S, Ou Z. Optimization of cleaning management improves the efficiency of the continuous surgery. American Journal of Nursing Science 9:107-111, 2020

Meneveau MO, Mehaffey JH, Turrentine FE, Shilling AM, Showalter SL, Schroen AT. Patient and personnel factors affect operating room start times. Surgery 167:390-395, 2020

Mitteregger M, Köhler G, Szyszkowitz A, Uranitsch S, Stiegler M, Aigner F, Schaffler-Schaden D. Increasing operating room efficiency with shop floor management: an empirical, code-based, retrospective analysis. Journal of Medical Systems 44:168, 2020

Monsey RD, Anderson CJ, Shorten PL, Lunardini DL, Tharp WG, Tsai MH. How engaged interdependence impacts operating room management metrics. Perioperative Care and Operating Room Management 18:100088, 2020

Pashankar DS, Zhao AM, Bathrick R, Taylor C, Boules H, Cowles RA, Grossman M. A quality improvement project to improve first case on-time starts in the pediatric operating room. Pediatric Quality and Safety 4:e305, 2020

Sonmez V, Pintelon L. A survey on performance management of operating rooms and a new KPI proposal. Quality and Reliability Engineering International 36:2595-2609, 2020

Tyerman Z, Mehaffey JH, Hawkins RB, Diop M, Carroll ND, Howell AM, Kern JA, Ailawadi G, Teman N. Nightly preoperative huddle email improves perioperative efficiency. The Annals of Thoracic Surgery 109:445-451, 2020


Allen RW, Taaffe KM, Neilley V, Busby E. First case on-time starts measured by incision on-time and no grace period: a case study of operating room management. Journal of Healthcare Management 64:111-121, 2019

Basto J, Chahal R, Riedel B. Time-driven activity-based costing to model the utility of parallel induction redesign in high-turnover operating lists. Healthcare 7:100355, 2019

Cerfolio RJ, Ferrari-Light D, Perry N, Rabinovich A, Saraceni M, Fitzpatrick M, Jain S, Pachter HL. Improving operating room turnover time in a New York City academic hospital via lean. The Annals of Thoracic Surgery 107:1011-1016, 2019

Chuang TYA, Yii N, Nyandowe M, Iyer R. Examine the impact of the implementation of an electronic medical record system on operating theatre efficiency at a teaching hospital in Australia. International Surgery Journal 6:1453-1457, 2019

Dexter F, Epstein RH, Schwenk ES. Tardiness of starts of surgical cases is not substantively greater when the preceding surgeon in an operating room is of a different versus the same specialty. Journal of Clinical Anesthesia 53:20-26, 2019

Dupont FW, Tung A, Shahul SS, Pohlman A, Joseph S, Gottlieb O, O'Connor MF, Cutter TW. Transport of critically ill patients by the anesthesia versus the intensive care unit service: a before-after study of operating room workflows. Anesthesia & Analgesia 129:671-678, 2019

Freeman N, Zhao M, Melouk S, Mittenthal J. The economics of overlapping surgeries. Production and Operations Management 28:2629-2652, 2019

Haldar R, Gupta D, Pandey H, Srivastava S, Mishra P, Agarwal A. Patient transportation delays and effects on operation theatres' efficiency: A study for problem analysis and remedial measures. Anesthesia Essays and Researches 13:554-559, 2019

Hoffman CR, Horrow J, Ranganna S, Green MS. Operating room first case start times: a metric to assess systems-based practice milestones? BMC Medical Education 19:446, 2019

Rowland MJ, Urman RD, Xu X, Ehrenfeld JM, Preiss DA, Vacanti JC. The impact of airway technique on anesthesia control time. Journal of Medical Systems 43:72, 2019

Saxena RC, Whipple ME, Neradilek MB, Solomon S, Fong CT, Nair BG, Lang JD. Does attending surgeon presence at the preinduction briefing improve operating room efficiency? Otolaryngology–Head and Neck Surgery 161:787-795, 2019

Sutkin G, Littleton EB, Kanter SL. Maintaining operative efficiency while allowing sufficient time for residents to learn. American Journal of Surgery 218:211-217, 2019


Coffey C Jr, Cho ES, Wei E, Luu A, Ho M, Amaya R, Pecson M, Dalton FV, Kahaku D, Spellberg B, Sener SF. Lean methods to improve operating room elective first case on-time starts in a large, urban, safety net medical center. The American Journal of Surgery 216:194-201, 2018

Dexter F, Jarvie C, Epstein RH. Lack of generalizability of observational studies' findings for turnover time reduction and growth in surgery based on the State of Iowa, where from one year to the next, most growth was attributed to surgeons performing only a few cases per week. Journal of Clinical Anesthesia 44:107-113, 2018  

Gul S. A stochastic programming approach for appointment scheduling under limited availability of surgery turnover teams. Service Science 10:277-288, 2018

Halim UA, Khan MA, Ali AM. Strategies to improve start time in the operating theatre: a systematic review. Journal of Medical Systems 42:160, 2018

Hoffman CR, Green MS, Liu J, Iqbal U, Voralu K. Using operating room turnover time by anesthesia trainee level to assess improving systems-based practice milestones. BMC Medical Education 18:295, 2018

Marrone SR. Perioperative accountable care teams: improving surgical team efficiency and work satisfaction through interprofessional collaboration. Journal of Perioperative Practice 28:223-230, 2018

Popat K, Gracia KA, Guzman AB, Feeley TW. Using time-driven activity-based costing to model the costs of various process-improvement strategies in acute pain management. Journal of Healthcare Management 63:e76-e85, 2018

Tiwari V, Ehrenfeld JM, Sandberg WS. Does a first-case on-time-start initiative achieve its goal by starting the entire process earlier or by tightening the distribution of start times? British Journal of Anaesthesia 121:1148-1155, 2018

Uddin M, Allen R, Huynh N, Vidal JM, Taaffe KM, Fredendall LD, Greenstein JS. Assessing operating room turnover time via the use of mobile application. mHealth 4:12, 2018


Doll D, Kauf P, Wieferich K, Schiffer R, Luedi MM. Implications of perioperative team setups for operating room management decisions. Anesthesia & Analgesia 124:262-269, 2017

Gleicher Y, Singer O, Choi S, McHardy P. Thoracic epidural catheter placement in a preoperative block area improves operating room efficiency and decreases epidural failure rate. Regional Anesthesia & Pain Medicine 42:649-651, 2017

Kumar M, Malhotra S. Reasons for delay in turnover time in operating room-an observational study. Bangladesh Journal of Medical Science 16:245-251, 2017

Maheshwari K, You J, Cummings KC 3rd, Argalious M, Sessler DI, Kurz A, Cywinski J. Attempted development of a tool to predict anesthesia preparation time from patient-related and procedure-related characteristics. Anesthesia & Analgesia 125:580-592, 2017

Martin L, Langell J. Improving on-time surgical starts: the impact of implementing pre-OR timeouts and performance pay. Journal of Surgical Research 219:222-225, 2017

McDowell J, Wu A, Ehrenfeld JM, Urman RD. Effect of the implementation of a new electronic health record system on surgical case turnover time. Journal of Medical Systems 41:42, 2017

Pan X, Zhang J, Dai C, Si Y. The effect of instructional supervision by an operating room assistant on first-case starts. Journal of PeriAnesthesia Nursing 32:58-63, 2017

Pedersen A, Getty Ritter E, Beaton M, Gibbons D. Remote video auditing in the surgical setting. AORN Journal 105:159-169, 2017

Pedron S, Winter V, Oppel EM, Bialas E. Operating room efficiency before and after entrance in a benchmarking program for surgical process data. Journal of Medical Systems 41:151, 2017

Phieffer L, Hefner JL, Rahmanian A, Swartz J, Ellison CE, Harter R, Lumbley J, Moffatt-Bruce SD. Improving operating room efficiency: first case on-time start project. Journal for Healthcare Quality 39:e70-e78, 2017

Souders CP, Catchpole KR, Wood LN, Solnik JM, Avenido RM, Strauss PL, Eilber KS, Anger JT. Reducing operating room turnover time for robotic surgery using a motor racing pit stop model. World Journal of Surgery 41:1943-1949, 2017

Tagge EP, Thirumoorthi AS, Lenart J, Garberoglio C, Mitchell KW. Improving operating room efficiency in academic children's hospital using Lean Six Stigma methodology. Journal of Pediatric Surgery 52:1040-1044, 2017

Uddin M, Allen R, Huynh N, Vidal JM, Taaffe KM, Fredendall LD, Greenstein JS. Effectiveness of a countdown timer in reducing or turnover time. Journal of Mobile Technology in Medicine 6:25-33, 2017


Al-Hakim L, Arora S, Sevdalis N. Impact of disruptions on anaesthetic workflow during anaesthesia induction and patient positioning: A prospective study. European Journal of Anaesthesiology 33:581-587, 2016

Allen RW, Pruitt M, Taaffe KM. Effect of resident involvement on operative time and operating room staffing costs. Journal of Surgical Education 73:979-985, 2016

Chen Y, Gabriel RA, Kodali BS, Urman RD. Effect of anesthesia staffing ratio on first-case surgical start time. Journal of Medical Systems 40:115, 2016

Clark A, Dackiw AP, White WD, Nwariaku FE, Holt SA, Rabaglia JL, Oltmann SC. Early endocrine attending surgeon presence increases operating room efficiency. Journal of Surgical Research 205:272-278, 2016

Fong AJ, Smith M, Langerman A. Efficiency improvement in the operating room. Journal of Surgical Research 204:371-383, 2016

Goebel U, Gebele N, Ebner W, Dettenkofer M, Bürkle H, Hauschke D, Schulz-Stübner S. Bacterial contamination of the anesthesia workplace and efficiency of routine cleaning procedures: a prospective cohort study. Anesthesia & Analgesia 122:1444-1447, 2016

Han SJ, Rolston JD, Zygourakis CC, Sun MZ, McDermott MW, Lau CY, Aghi MK. Preventing delays in first-case starts on the neurosurgery service: a resident-led initiative at an academic institution. Journal of Surgical Education 73:291-295, 2016

House LM, Calloway NH, Sandberg WS, Ehrenfeld JM. Prolonged patient emergence time among clinical anesthesia resident trainees. Journal of Anaesthesiology, Clinical Pharmacology 32:446-452, 2016

Kacmar RM, Davidson BM, Victor M, Bullard K, Melendez J. Using an at-risk salary model to improve throughput in academic medical center operating rooms. Journal of Clinical Anesthesia 34:416-419, 2016

Khambhammettu M, Persson M. Analyzing a decision support system for resource planning and surgery scheduling. Procedia Computer Science 100:532-538, 2016

Luedi MM, Kauf P, Mulks L, Wieferich K, Schiffer R, Doll D. Implications of patient age and ASA physical status for operating room management decisions. Anesthesia & Analgesia 122:1169-1177, 2016

Mascarella MA, Lahrichi N, Cloutier F, Kleiman S, Payne RJ, Rosenberg L. High efficiency endocrine operation protocol: from design to implementation. Surgery 160:1118-1124, 2016

Mizumoto R, Cristaudo AT, Hendahewa R. A surgeon-led model to improve operating theatre change-over time and overall efficiency: a randomised controlled trial. International Journal of Surgery 30:83-89, 2016

Overdyk FJ, Dowling O, Newman S, Glatt D, Chester M, Armellino D, Cole B, Landis GS, Schoenfeld D, DiCapua JF. Remote video auditing with real-time feedback in an academic surgical suite improves safety and efficiency metrics: a cluster randomised study. BMJ Quality & Safety 25:947-953, 2016

Ramos P, Bonfá E, Goulart P, Medeiros M, Cruz N, Puceh-Leão P, Feiner B. First-case tardiness reduction in a tertiary academic medical center operating room: a lean six sigma perspective. Perioperative Care and Operating Room Management 5:7-12, 2016

Reznick D, Niazov L, Holizna E, Keebler A, Siperstein A. Dedicated teams to improve operative room efficiency. Perioperative Care and Operating Room Management 3:1-5, 2016

Scagliarini M, Apreda M, Wienand U, Valpiani G. Monitoring operating room turnaround time: a retrospective analysis. International Journal of Health Care Quality Assurance 29:351-359, 2016

Sharif H, Shehzad N, Farooqi J, Karim S, Akbar S. Bringing efficiency into practice: a quality improvement initiative to reduce operating room turnaround time. Journal of Pakistan Medical Association 66:S8-S11, 2016

Szczesny A, Ernst C. The role of performance reporting system characteristics for the coordination of high-cost areas in hospitals. European Accounting Review 25:635-660, 2016

Weld LR, Stringer MT, Ebertowski JS, Baumgartner TS, Kasprenski MC, Kelley JC, Cho DS, Tieva EA, Novak TE. TeamSTEPPS improves operating room efficiency and patient safety. American Journal of Medical Quality 31:408-414, 2016


Brown MJ, Kor DJ, Curry TB, Marmor Y, Rohleder TR. A coordinated patient transport system for ICU patients requiring surgery: impact on operating room efficiency and ICU workflow. Journal for Healthcare Quality 37:354-362, 2015

Caggiano NM, Avery DM 3rd, Matullo KS. The effect of anesthesia type on nonsurgical operating room time. The Journal of Hand Surgery 40:1202-1209, 2015

Mathews L, Kla KM, Marolen KN, Sandberg WS, Ehrenfeld JM. Measuring and improving first case on-time starts and analysis of factors predicting delay in neurosurgical operating rooms. Journal of Neurosurgical Anesthesiology 27:203-208, 2015

Mulier JP, De Boeck L, Meulders M, Beliën J, Colpaert J, Sels A. Factors determining the smooth flow and the non-operative time in a one-induction room to one-operating room setting. Journal of Evaluation in Clinical Practice 21:205-214, 2015

Pimentel MT, Flanagan H, Philip BK, Urman RD. Qualitative analysis of barriers to efficient operating room turnovers in a tertiary care academic medical center. The Journal of Medical Practice Management 30:30-35, 2015

Saw N, Vacanti JC, Liu X, SaRego M, Flanagan H, Kodali BS, Urman RD. Process redesign to improve first case surgical starts in an academic institution. Journal of Investigative Surgery 28:95-102, 2015

van Veen-Berkx E, Elkhuizen SG, van Logten S, Buhre WF, Kalkman CJ, Gooszen HG, Kazemier G; Dutch Operating Room Benchmarking Collaborative. Enhancement opportunities in operating room utilization; with a statistical appendix. Journal of Surgical Research 194:43-51, 2015


Austin TM, Lam HV, Shin NS, Daily BJ, Dunn PF, Sandberg WS. Elective change of surgeon during the OR day has an operationally negligible impact on turnover time. Journal of Clinical Anesthesia 26:343-349, 2014

Avery DM III, Matullo KS. The efficiency of a dedicated staff on operating room turnover time in hand surgery. The Journal of Hand Surgery 39:108-110, 2014

Bhatt AS, Carlson GW, Deckers PJ. Improving operating room turnover time: a systems based approach. Journal of Medical Systems 38:148, 2014

Brown MJ, Subramanian A, Curry TB, Kor DJ, Moran SL, Rohleder TR. Improving operating room productivity via parallel anesthesia processing. International Journal of Health Care Quality Assurance 27:697-706, 2014

Del Signore AG, Dang R, Yerasi A, Iloreta AM, Malkin BD. Videoconferencing for the pre-operative interaction between patient and surgeon. Journal of Telemedicine and Telecare 20:267-271, 2014

Kodali BS, Kim D, Bleday R, Flanagan H, Urman RD. Successful strategies for the reduction of operating room turnover times in a tertiary care academic medical center. Journal of Surgical Research 187:403-411, 2014

Kodali BS, Kim KD, Flanagan H, Ehrenfeld JM, Urman RD. Variability of subspecialty-specific anesthesia-controlled times at two academic institutions. Journal of Medical Systems 38:11, 2014

Luo L, Yao DD, Huang X, You Y, Cheng Y, Shi Y, Liu J, Gong R. Sequence-dependent anesthesia-controlled times: a retrospective study in an ophthalmology department of a single-site hospital. Anesthesia & Analgesia 119:151-162, 2014

Scalea TM, Carco D, Reece M, Fouche YL, Pollak AN, Nagarkatti SS. Effect of a novel financial incentive program on operating room efficiency. JAMA Surgery 149:920-924, 2014

van Veen-Berkx E, Elkhuizen SG, Kalkman CJ, Buhre WF, Kazemier G. Successful interventions to reduce first-case tardiness in Dutch university medical centers: results of a nationwide operating room benchmark study. The American Journal of Surgery 207:949-959, 2014

Yeo CH, Gordon R, Nusem I. Improving operating theatre communication between the orthopaedics surgeon and radiographer. ANZ Journal of Surgery 84:316-319, 2014


Dexter F, Epstein RH. Increased mean time from end of surgery to operating room exit in a historical cohort of cases with prolonged time to extubation. Anesthesia & Analgesia 117:1453-1459, 2013  

Epstein RH, Dexter F, Brull SJ. Cohort study of cases with prolonged tracheal extubation times to examine the relationship with duration of workday. Canadian Journal of Anaesthesia 60:1070-1076, 2013  

Panni MK, Shah SJ, Chavarro C, Rawl M, Wojnarwsky PK, Panni JK. Improving operating room first start efficiency - value of both checklist and a pre-operative facilitator. Acta Anaesthesiologica Scandinavica 57:1118-1123, 2013

Papaconstantinou HT, Smythe WR, Reznik SI, Sibbitt S, Wehbe-Janek H. Surgical safety checklist and operating room efficiency: results from a large multispecialty tertiary care hospital. The American Journal of Surgery 206:853-860, 2013

Porta CR, Foster A, Causey MW, Cordier P, Ozbirn R, Bolt S, Allison D, Rush R. Operating room efficiency improvement after implementation of a postoperative team assessment. Journal of Surgical Research 180:15-20, 2013

Radcliff KE, Rasouli MR, Neusner A, Kepler CK, Albert TJ, Rihn JA, Hilibrand AS, Vaccaro AR. Preoperative delay of more than 1 hour increases the risk of surgical site infection. Spine 38:1318-1323, 2013

Schuster M, Pezzella M, Taube C, Bialas E, Diemer M, Bauer M. Delays in starting morning operating lists: an analysis of more than 20,000 cases in 22 German hospitals. Deutsches Arteblatt International 110:237-243, 2013

Varu VN, Greenberg JI, Lee JT. Improved efficiency and safety for EVAR with utilization of a hybrid room. European Journal of Vascular and Endovascular Surgery 46:675-679, 2013

Wang J, Dexter F, Yang K. A behavioral study of daily mean turnover times and first case of the day start tardiness. Anesthesia & Analgesia 116:1333-1141, 2013  

Warner CJ, Walsh DB, Horvath AJ, Walsh TR, Herrick DP, Prentiss SJ, Powell RJ. Lean principles optimize on-time vascular surgery operating room starts and decrease resident work hours. Journal of Vascular Surgery 58:1417-1422, 2013


Collar RM, Shuman AG, Feiner S, McGonegal AK, Heidel N, Duck M, McLean SA, Billi JE, Healy DW, Bradford CR. Lean management in academic surgery. Journal of the American College of Surgeons 214:928-936, 2012

Ernst C, Szczesny A, Soderstrom N, Siegmund F, Schleppers A. Success of commonly used operating room management tools in reducing tardiness of first case of the day starts: evidence from german hospitals. Anesthesia & Analgesia 115:671-677, 2012

Masursky D, Dexter F, Kwakye MO, Smallman B. Measure to quantify the influence of time from end of surgery to tracheal extubation on operating room workflow. Anesthesia & Analgesia 115:402-406, 2012  

Urman RD, Sarin P, Mitani A, Philip B, Eappen S. Presence of anesthesia resident trainees in day surgery unit has mixed effects on operating room efficiency measures. The Ochsner Journal 12:25-29, 2012

Varughese AM, Hagerman N, Patino M, Wittkugel E, Schnell B, Salisbury S, Kurth D. A comparison of inhalational inductions for children in the operating room vs the induction room. Paediatric Anaesthesia 22:327-334, 2012


Cima RR, Brown MJ, Hebl JR, Moore R, Rogers JC, Kollengode A, Amstutz GJ, Weisbrod CA, Narr BJ, Deschamps C. Use of lean and six sigma methodology to improve operating room efficiency in a high-volume tertiary-care academic medical center. Journal of the American College of Surgeons 213:83-92, 2011

Head SJ, Seib R, Osborn JA, Schwarz SK. A "swing room" model based on regional anesthesia reduces turnover time and increases case throughput. Canadian Journal of Anesthesia 58:725-732, 2011

Jericó Mde C, Perroca MG, Penha VC. Measuring quality indicators in the operating room: cleaning and turnover time. Revista Latino-Americana de Enfermagem 19:1239-1246, 2011

Masursky D, Dexter F, Isaacson SA, Nussmeier NA.  Surgeons’ and anesthesiologists’ perceptions of turnover times. Anesthesia & Analgesia 112:440-444, 2011  

Wachtel RE, Dexter F, Epstein RH, Ledolter J. Meta-analysis of desflurane and propofol average times and variability in times to extubation and following commands. Canadian Journal of Anesthesia 58:714-724, 2011  


Dexter F, Bayman EO, Epstein RH. Statistical modeling of average and variability of time to extubation for meta-analysis comparing desflurane to sevoflurane. Anesthesia & Analgesia 110:570-580, 2010  

Stepaniak PS, Vrijland WW, de Quelerij M, de Vries G, Heij C. Working with a fixed operating room team on consecutive similar cases and the effect on case duration and turnover time. Archives of Surgery 145:1165-1170, 2010

Wolf FA, Way LW, Stewart L. The efficacy of medical team training: improved team performance and decreased operating room delays: a detailed analysis of 4863 cases. Annals of Surgery 252:477-483, 2010

Wright JG, Roche A, Khoury AE. Improving on-time surgical starts in an operating room. Canadian Journal of Surgery 53:167-170, 2010


Dexter F, Marcon E, Aker J, Epstein RH. Numbers of simultaneous turnovers calculated from anesthesia or operating room information management system data. Anesthesia & Analgesia 109:900-905, 2009  

Mariano ER, Chu LF, Peinado CR, Mazzei WJ. Anesthesia-controlled time and turnover time for ambulatory upper extremity surgery performed with regional versus general anesthesia. Journal of Clinical Anesthesia 21:253-257, 2009

Marjamaa RA, Torkki PM, Hirvensalo EJ, Kirvelä OA. What is the best workflow for an operating room? A simulation study of five scenarios. Health Care Management Science 12:142-146, 2009


Krupka DC, Sathaye S, Sandberg WS. Reducing non-operative time: methods and impact on operating room economics. International Journal of Healthcare Technology and Management 19:325-352, 2008

Nundy S, Mukherjee A, Sexton JB, Pronovost PJ, Knight A, Rowen LC, Duncan M, Syin D, Makary MA. Impact of preoperative briefings on operating room delays: a preliminary report. Archives of Surgery 143:1068-1072, 2008

Schuster M, Kotjan T, Fiege M, Goetz AE. Influence of resident training on anaesthesia induction times. British Journal of Anaesthesia 101:640-647, 2008

Smith MP, Sandberg WS, Foss J, Massoli K, Kanda M, Barsoum W, Schubert A. High-throughput operating room system for joint arthroplasties durably outperforms routine processes. Anesthesiology 109:25-35, 2008

Vigoda MM, Gayer S, Tutiven J, Mueller A, Murtha M, Schefler AC, Murray TG. Targeting operating room inefficiencies in the complex management of vision-threatening diseases in children. Archives of Ophthalmology 126:1241-1243, 2008


Eappen S, Flanagan H, Lithman R, Bhattacharyya N. The addition of a regional block team to the orthopedic operating rooms does not improve anesthesia-controlled times and turnover time in the setting of long turnover times. Journal of Clinical Anesthesia 19:85-91, 2007

Seim AR, Dahl DM, Sandberg WS. Small changes in operative time can yield discrete increases in operating room throughput. Journal of Endourology 21:703-708, 2007


Cendan JC, Good M. Interdisciplinary work flow assessment and redesign decreases operating room turnover time and allows for additional caseload. Archives of Surgery 141:65-69, 2006

Friedman DM, Sokal SM, Chang Y, Berger DL. Increasing operating room efficiency through parallel processing. Annals of Surgery 243:10-14, 2006

Harders M, Malangoni MA, Weight S, Sidhu T. Improving operating room efficiency through process redesign. Surgery 140:509-516, 2006

Seim A, Andersen B, Sandberg WS. Statistical process control as a tool for monitoring nonoperative time. Anesthesiology 105:370-380, 2006

Stahl JE, Sandberg WS, Daily B, Wiklund R, Egan MT, Goldman JM, Isaacson KB, Gazelle S, Rattner DW. Reorganizing patient care and workflow in the operating room: a cost-effectiveness study. Surgery 139:717-728, 2006


Dexter F, Epstein RH, Marcon E, Ledolter J. Estimating the incidence of prolonged turnover times and delays by time of day. Anesthesiology 102:1242-1248, 2005  

Dexter F. Deciding whether your hospital can apply clinical trial results of strategies to increase productivity by reducing anesthesia and turnover times. Anesthesiology 103:225-228, 2005  

Hanss R, Buttgereit B, Tonner PH, Bein B, Schleppers A, Steinfath M, Scholz J, Bauer M. Overlapping induction of anesthesia: An analysis of benefits and costs. Anesthesiology 103:391-400, 2005

Pakdil F, Harwood TN. Factors that influence efficiency in performing ENT cases: A qualitative and quantitative analysis. Journal of Medical Systems 29:285-301, 2005

Sandberg WS, Daily B, Egan M, Stahl JE, Goldman JM, Wiklund RA, Rattner D. Deliberate perioperative systems design improves operating room throughput. Anesthesiology 103:406-418, 2005

Schuster M, Standl T, Reissmann H, Kuntz L, Am Esch JS. Reduction of anesthesia process times after the introduction of an internal transfer pricing system for anesthesia services. Anesthesia & Analgesia 101:187-194, 2005

Torkki PM, Marjamaa RA, Torkki MI, Kallio PE, Kirvela OA. Use of anesthesia induction rooms can increase the number of urgent orthopedic cases completed within 7 hours. Anesthesiology 103:401-405, 2005


Abouleish AE, Dexter F, Whitten CW, Zavaleta JR, Prough DS. Quantifying net staffing costs due to longer-than-average surgical case durations. Anesthesiology 100:403-412, 2004  

Adams R, Warner P, Hubbard B, Goulding T. Decreasing turnaround time between general surgery cases. Journal of Nursing Administration 34:140-148, 2004

Armstrong KP, Cherry RA. Brachial plexus anesthesia compared to general anesthesia when a block room is available. Canadian Journal of Anesthesia 51:41-44, 2004

Babineau TJ, Becker J, Gibbons G, Sentovich S, Hess D, Robertson S, Stone M. The "cost" of operating training for surgical residents. Archives of Surgery 139:366-370, 2004

Drolet P, Girard M. Regional anesthesia, block room and efficiency: putting things in perspective. Canadian Journal of Anesthesia 51:41-44, 2004

Gupta A, Stierer T, Zuckerman R, Sakima N, Parker SD, Fleisher LA. Comparison of recovery profile after ambulatory anesthesia with propofol, isoflurane, sevoflurane, and desflurane: a systematic review. Anesthesia & Analgesia 98:632-641, 2004

Hsiao KC, Machaidze Z, Pattaras JG. Time management in the operating room: an analysis of the dedicated minimally invasive surgery suite. Journal of the Society of Laparoendoscopic Surgeons 8:300-3, 2004

Koperna T. How long do we need teaching in the operating room? The true costs of achieving surgical routine. Langenbecks Archives of Surgery 389:204-8, 2004

Stahl JE, Rattner D, Wiklund R, Lester J, Beinfeld M, Gazelle GS. Reorganizing the system of care surrounding laparoscopic surgery: a cost-effectiveness analysis using discrete-event simulation. Medical Decision Making 24:461-471, 2004


Champault A, Arsena V, Barrat C, Bayeh P, Champault G. Can the time between interventions be reduced in the operating theater? Ann Chir 128:599-602, 2003

Dexter F, Abouleish AE, Epstein RH, Whitten CW, Lubarsky DA. Use of operating room information system data to predict the impact of reducing turnover times on staffing costs. Anesthesia & Analgesia 97:1119-1126, 2003  


Sokolovic E, Biro P, Wyss P, Werthemann C, Haller U, Spahn D, Szucs T. Impact of the reduction of anaesthesia turnover time on operating room efficiency. European Journal of Anaesthesiology 19:560-563, 2002


Kenyon TA, Urbach DR, Speer JB, Waterman-Hukari B, Foraker GF, Hansen PD, Swanstrom LL. Dedicated minimally invasive surgery suites increase operating room efficiency. Surgical Endoscopy 15:1140-1143, 2001


Williams BA, Kentor ML, Williams JP, Figallo CM, Sigl JC, Anders JW, Bear TC, Tullock WC, Bennett CH, Harner CD, Fu FH. Process analysis in outpatient knee surgery - Effects of regional and general anesthesia on anesthesia-controlled time. Anesthesiology 93:529-538, 2000


Dexter F, Macario A, Manberg PJ, Lubarsky DA. Computer simulation to determine how rapid anesthetic recovery protocols to decrease the time for emergence or increase the phase I post anesthesia care unit bypass rate affect staffing of an ambulatory surgery center. Anesthesia & Analgesia 88:1053-1063, 1999  

Dexter F, Macario A. Decrease in case duration required to complete an additional case during regularly scheduled hours in an operating room suite - a computer simulation study. Anesthesia & Analgesia 88:72-76, 1999  

Kain ZN, Faulo A, Rimar S. Establishment of a pediatric surgery center: Increasing anesthetic efficiency. Journal of Clinical Anesthesia 11:540-544, 1999


Overdyk FJ, Harvey SC, Fishman RL, Shippey F. Successful strategies for improving operating room efficiency at academic institutions. Anesthesia & Analgesia 86:896-906, 1998

Williams BA, DeRiso BM, Engel LB, Figallo CM, Anders JW, Engel LB, Sproul KA, Ilkin H, Harner CD, Fu FH, Nagarajan NJ, Evans JH 3rd, Watkins WD. Benchmarking the Perioperative process: III. Effects of regional anesthesia clinical pathway techniques on process efficiency and recovery profile in ambulatory orthopedic surgery. Journal of Clinical Anesthesia 10:570-578, 1998

Williams BA, DeRiso BM, Engel LB, Figallo CM, Anders JW, Sproul KA, Ilkin H, Harner CD, Fu FH, Nagarajan NJ, Evans JH 3rd, Watkins WD. Benchmarking the Perioperative process: II. Introducing anesthesia clinical pathways to improve processes and outcomes and to reduce nursing labor intensity in ambulatory orthopedic surgery. Journal of Clinical Anesthesia 10:561-569, 1998


Dexter F, Macario A. Applications of information systems to operating room scheduling. Anesthesiology 85:1232-1234, 1996  


Dexter F, Coffin S, Tinker JH. Decreases in anesthesia-controlled time cannot permit one additional surgical operation to be scheduled during the workday. Anesthesia & Analgesia 81:1263-1268, 1995  

Dexter F, Tinker JH. Comparisons between desflurane and isoflurane or propofol on time to following commands and time to discharge: a metaanalysis. Anesthesiology 83:77-82, 1995  


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