Operating room (OR) is a cost-intensive environment, and it should be managed efficiently. When improving efficiency, shortening case duration by parallel processing, training of the resident surgeons, the choice of anesthetic methods, effective scheduling, and monitoring of the overall OR performance are important. When redesigning the OR processes, changes should be given a clear target and the achieved results monitored and reported to everyone involved. Advanced, reliable, and easy to use information technology solutions for OR management are under development. Pre-operative clinic and functionally designed facilities support efficiency. OR personnel must be kept motivated by clear management and leadership, supported by superiors.

We explored whether there were large differences in operating room (OR) times for two common procedures performed by multiple surgeons at each of several hospitals thousands of miles apart. Mean OR time, "wheels in" to "wheels out," for ten consecutive cases of each of laparoscopic cholecystectomy and lung lobectomy were obtained for each of ten hospitals in eight countries from their OR logs. After log transformation, the OR times were analyzed by analysis of variance. Mean OR times differed significantly among hospitals (P = 0.006, laparoscopic cholecystectomy; P < 0.001, lung lobectomy). The second longest average OR time was 50% longer than the second shortest average OR time for both laparoscopic cholecystectomy and lung lobectomy. Differences in OR times among the hospitals we studied were large enough to affect the productivity of OR nurses and anesthesia providers. Thus, international benchmarking studies to understand differences in OR times worldwide may be beneficial.

The online version of the original article can be found at http://dx