Date of Award

Spring 2022

Document Type

Project – Full Written

Degree Name

Doctor of Nursing Practice (DNP)

Committee Chair

Cindy Miller



Many operating rooms across the country face the daunting task of making their turnovers between surgical patients quicker and more efficient. Turnover time is defined as the time it takes to clean an operating room and set up the next sterile field between surgical patients. The time begins when the patient leaves the operating room suite and stops when the next patient enters the same suite. Running an operating room is a complex and costly endeavor, and even small shortfalls can have a snowball effect, leading to delays, wasteful spending, and substandard patient outcomes; therefore, it is imperative to have the turnover process be as efficient as possible. The anticipated overall goal of implementing Lean principles during the operating room turnover process is to improve efficiency and eliminate waste.


The methodology for this quality improvement project consisted of observing the current operating room turnover process and establishing a project team to evaluate the data. The team analyzed the process by utilizing the Lean principles and broke down each step of the turnover process and reconfigured the steps. After the steps were reconfigured into a new process, the improved steps were implemented during the turnovers.


The project lead and the project lead team designed and trained their colleagues on the new turnover process. The project lead team members continuously monitored, offered opportunities for improvement, and encouraged staff to use the new process. Prior to implementation, the project lead administered a pre-implementation employee satisfaction survey to all operating room staff. This survey was compared to a post-implementation employee satisfaction survey to determine how the project affected employee satisfaction. Each month the project leaders met with the administrative team to discuss average monthly turnover times, and incident reports.


The process was implemented and observed for 3 months. During this time the monthly turnover time decreased by 0.5 minutes for 2 of the 3 months observed, zero-incident reports were reported or collected pertaining to the project, but employee satisfaction scores dropped from a pre-implementation average score of 36.7 to a post-implementation average score of 32.3. The surgery center also did not see an increase in expenses of on-boarding new employees due to the implementation of the project. The employee satisfaction scores decreased because of an increase in stress felt by the staff. High-stress levels were caused by an increase in patient volume due to the time of year, pandemic fatigue, and from still adjusting to a new electronic medical record.


With the rising cost of health care, opportunities exist to improve patient safety, minimize delays and waste, increase operating room use, and enhance the perioperative experience for the patient, family, and the perioperative team members. While this project did not meet all its intended objectives, it will still have a lasting impact on the surgery center. With assistance from management to continue encouraging and monitoring the turnover process, the project will be sustained.

Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License