• James E McGowan, Jonathon D Truwit, Pam Cipriano, R Edward Howell, Margaret VanBree, Arthur Garson, and John B Hanks.
• Health System Administration, University of Virginia Health Systems, Charlottesville, VA 22908, USA.
• J. Am. Coll. Surg. 2007 May 1;204(5):865-71; discussion 871-2.

BackgroundAcademic medical centers are faced with increasing volumes, higher acuity, and, as a consequence, capacity issues. These affect operating room (OR) use and patient throughput, with negative impact on finances and patient and physician satisfaction. We evaluated our experiences in dealing with OR efficiency at a time of maximum hospital capacity and occupancy.Study DesignUsing a multidisciplinary approach, we put in place seven agreed-upon strategies: daily communication, improved bed planning, discharge by noon program, internal staffing pool, special assignments for a patient transition unit, incentives, and stepped up environmental services.ResultsAfter institution of these strategies, we were able to realize a gain in OR patient volume of 8% and a decrease in OR holds of 37%. This resulted in a decrease in canceled OR cases from 4.3% to 3.1%.ConclusionsAcademic medical centers face occupancy issues that are not likely to go away and will have an impact on OR volume and productivity. To improve the situation in a short-term fashion, a multidisciplinary approach involving several strategies will be needed.

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