23227108

AI Video Metrics Help Improve Operating Room Efficiency

Thu, 22 Jan 2026 01:35:39 GMT

Lead With Empathy Not Enforcment

Using Video-Based Metrics and Parallel Processing to Improve Operating Room Efficiency: A Quality Improvement Initiative

Jay Redan MD; Nicholas DeStefano BSN, RN, CNOR; Asem Ghaniam MD, Micheal McDonald MD; Rhandie DeGracia BSN, RN; Baky Potter-Perez BSN, RN, CNOR; Delilah Ortega MSN, RN, RNFA; Jaseem Khan, BSN, RN, CNOR; Frederick Pilapil RN, CNOR; Felcar Nunez MSN, RN, CSSYB, Megan Nylander RT

Abstract

Operating Room (OR) efficiency is often hampered by inaccurate, manually documented timestamps and process variability. This quality improvement study utilized real-time Artificial Intelligence (AI) video analytics to deconstruct surgical cases into four timestamped segments. By identifying bottlenecks specifically regarding on-time starts and turnover variability the facility implemented a "T-Minus" readiness protocol and a parallel processing strategy. Results showed a year-over-year increase in on-time starts from 64% to 71%, reaching a record 78.45% in May 2025, and a reduction in average turnover time by 2 minutes. This study demonstrates that AI-driven data transparency, combined with multidisciplinary coordination, can significantly increase case capacity and expedited patient care.

Introduction

Efficiency in the Operating Room is critical for financial viability and patient safety. However, manually documented OR timestamps are historically highly variable and inaccurate due to the multitude of concurrent tasks required by the surgical team. This variability often obscures the root causes of delays, creating disruptions in the patient care continuum.

Initial Quality Assurance (QA) audits at our facility revealed a concerning dip in on-time starts from 66.5% to 61.87%, despite positive patient outcomes and low infection rates. The data highlighted a paradoxical phenomenon: staff were often waiting in a fully ready OR, but the patient was not present. As noted by Parmar et al. (2024), understanding the root causes of first-case delays is essential for elective surgical procedure efficiency.

This article outlines the implementation of video-based AI metrics to "see" and deconstruct operational segments, leading to the development of a "T-Minus" protocol and parallel processing strategies that mirror a "motocross pitstop" approach to safety and speed.

Methodology

Real-Time Video Analytics

The facility integrated real-time video analytics to record and timestamp four specific segments of the operative procedure:

Patient In to First Incision: Tasks required before the procedure begins (e.g., anesthesia induction, positioning, draping).
Incision to Closure: The operative phase.
Surgery Complete to Patient Out: Emergence and transfer.
Wheels Out to Wheels In: Room turnover and preparation for the next patient.

Data Discovery

AI analysis revealed a critical correlation: for every minute a case started late, it added another three minutes to the out-of-room time, creating compounding delays into the afternoon. Furthermore, heatmaps indicated that staff were frequently waiting for first cases, and significant time was lost between cases before setup for the next patient even began.

The "T-Minus" Protocol

A centralized HealthPass (Preadmission Testing) initiative, while designed for patient access, created gaps in chart readiness (missing H&Ps, consents, labs). To address this, a Patient Care Coordinator position was created to audit charts and manage a "T-Minus" protocol. This protocol created standardized touchpoints at specific intervals (24 hours out, 90 mins out, etc.) to ensure the patient, surgeon, and room were synchronized.

Figure 1: The T-Minus Protocol outlining multidisciplinary responsibilities leading up to the scheduled case start.

Results

On-Time Starts

Following the implementation of the Patient Care Coordinator and T-Minus protocol, on-time starts increased year-over-year from 64% to 71%. The facility achieved a 6-year record of 78.45% on-time starts in May 2025.

Turnover Efficiency

Video data analysis provided a granular look at the total OR time by subprocess, highlighting variation.

Figure 2: Analysis of Total OR Time by SubProcess as a percent of Total OR Time.

Heatmaps identifying turnover times by day of the week and hour of the day revealed that turnover times lengthened significantly as the day progressed.

Figure 3: Heatmap illustrating turnover time variation by day and hour.

Regression analysis indicated that greater than 70% of turnover variation could be explained by the hour of the day.

Figure 4: Turnover Time versus Hour of Surgery regression analysis.

By standardizing roles and implementing parallel processing where tasks such as the nurse counting and the tech prepping occur simultaneously average turnover times were reduced by 2 minutes.

Figure 5: Distribution of Patient Turnover Times showing a shift toward the target duration.

The reduction in turnover minutes cumulatively gained back hours of operating time, resulting in the highest volume year the facility had ever seen.

Figure 6: Comparison of Room Turnover times before and after implementation.

Discussion

Parallel Processing Strategy

The core intervention involved moving from sequential to parallel processing. As Sales-Coll et al. (2021) suggest, lean management tools are vital for improving efficiency. This study applied those principles to the four timestamped segments:

Segment 1 (Entry to Incision): While the circulator counts the back table, the anesthesia team, coordinator, and surgical aide simultaneously assist in transfer and intubation. The scrub tech begins draping immediately as the circulator completes the foley catheter.
Segment 4 (Turnover): The surgeon dictates notes and visits the family immediately upon "wheels out," rather than delaying. Simultaneously, the preoperative team begins IVs and verification for the next patient, while the Coordinator checks the next case cart before the room is even clean.

Addressing Variation

The data revealed that "standard" turnover roles degraded during lunch hours. A new iteration of the process was created to manage breaks without disrupting the flow, keeping preferred teams with their surgeons to reduce instrumentation errors.

Interestingly, while most rooms saw dramatic reductions, some (e.g., OR 1 and GYN) saw increases. Further data drilling revealed context hidden by simple averages: OR 1 was handling direct ICU transfers, and the GYN service had shifted to more complex cases compared to previous months. This underscores the necessity of AI-driven optimization to understand the context of delays, as supported by Seal (2024).

Conclusion

By integrating real-time AI video timestamps, this facility successfully moved from anecdotal evidence to metric-based improvement. The combination of the T-Minus protocol for pre-operative readiness and parallel processing for intra-operative efficiency resulted in a safer, highly functioning environment. This approach not only respected the patient's time but unlocked significant capacity for the hospital system.

References

Parmar, A., Rathod, K., Sharma, S., Singh, A., & Wani, S. (2024). Root causes of first-case start time delays for elective surgical procedures: A quality improvement study. Patient Safety in Surgery , 18(1), 1-6. https://doi.org/10.1186/s13037-024-00405-z

Proximie INC. Proxime Surgical Telepresence & Intelligence Suite Platform; Operating Room Efficiency (ORE) Study: AdventHealth Celebration

Sales-Coll, M., de Castro, R., & Hueto-Madrid, J. A. (2021). Improving operating room efficiency using lean management tools. Production Planning & Control , 34(13), 1261–1274. https://doi.org/10.1080/09537287.2021.1998932

Seal, S. (2024). AI-driven optimization of hospital operating rooms: A case study. International Journal of Computer Trends and Technology (IJCTT) , 72(10), 5–8. https://ijcttjournal.org/Volume-72%20Issue-10/IJCTT-V72I10P102.pdf?utm_source=

The Sullivan Group. (n.d.). Perioperative safety and reliability consulting services. https://www.thesullivangroup.com/RSQSolutions/

AORN Clinical Improvement and Innovation

Sun, 06 Jul 2025 20:51:21 GMT

How One Hospital Stopped a Neurosurgical Infection Outbreak: Lessons from AORN 2025

At this year’s AORN Global Surgical Conference, we (Nicholas DeStefano, OR Nurse Manager, and Charles Vickery, Surgical Infection Preventionist at AdventHealth Celebration) had the honor of sharing a story that underscores the power of collaboration and the critical role of infection prevention in the operating room.

Our session, “Bacteria in Brain Surgery: The Infection Preventionist Response”, walked attendees through the journey of how a multidisciplinary team at our hospital identified and eradicated a cluster of craniotomy-related surgical site infections (SSIs). Here's a recap of what we shared and the key takeaways.

�� The Problem: A Rise in Neurosurgical Infections

In 2021, our surgical services team identified a disturbing spike in craniotomy infections — five cases in a short span, all linked to the bacterium Serratia marcescens. This organism, which thrives in moist environments like tap water and soap dispensers, isn't typically found on skin. Yet somehow, it had made its way into our ORs.

Through detailed chart reviews, culture analysis, and staff reports, we knew we were facing more than isolated incidents — we had a cluster outbreak.

�� The Response: Building a Multidisciplinary Task Force

Rather than handle the situation in silos, we formed a dynamic task force. Infection Prevention, Environmental Services, SPD (Sterile Processing Department), Supply Chain, Perioperative Leadership, and our C-suite came together.

We implemented:

Enhanced environmental testing (air, water, surfaces)
Daily OR audits
Instrument tracing protocols
New head holder inventory (to address non-compliant IFU cleaning practices)
Point-of-use cleaning education

All of these actions were rooted in real-time data and open communication — two of the most powerful tools in healthcare.

��‍⚕️ The Impact of a Surgical Infection Preventionist

One of the biggest turning points was the creation of a dedicated Surgical Infection Preventionist role — a rare but increasingly vital position in hospitals. Charles, a former ICU nurse turned IP, immersed himself in OR culture, bridged knowledge gaps, and became a trusted resource for staff and surgeons alike.

Since the implementation of this role:

Craniotomy SSIs dropped to zero between 2022–2024
Cost savings exceeded $200,000
Surgeon and staff buy-in increased significantly
Patient safety and outcomes improved across the board

�� Return on Investment: Quality and Cost Benefits

Healthcare-associated infections cost the U.S. over $3 billion annually , with SSIs making up 20% of that burden. In our facility alone, avoiding just a handful of infections saved hundreds of thousands of dollars — proving the value of prevention over treatment.

�� A Call to Action: Bring the Surgical IP to Your OR

If you’re considering building a similar role in your OR, we encourage you to:

Show the data : Highlight infection trends and potential savings.
Secure surgeon support : Surgeons respect outcomes and peer-led change.
Build your team : Collaboration is the engine of transformation.

As we like to say, "Infection prevention in the OR is one of the greatest things we can do when patients are at their most vulnerable."

�� For More Info:
Read the full article from Infection Control Today:
�� https://www.infectioncontroltoday.com/view/collaboration-action-how-one-hospital-stopped-neurosurgical-infection-outbreak

✉️ Questions? Reach out to us — we’d love to help you build your case for a surgical IP!

The Importance of Self-Care for Nurses

Sat, 03 May 2025 19:43:47 GMT

Self-care is crucial for nurses, who often face long hours, high-stress environments, and emotionally demanding situations. Prioritizing self-care is not only beneficial for personal well-being but also essential for providing high-quality patient care. Here are key reasons why self-care is important for nurses.

BOOSTS PHYSICAL HEALTH

Eating well, exercising, and getting adequate sleep are essential self-care strategies that help nurses maintain the stamina required for long shifts and demanding workloads.

Reduces Compassion Fatigue: Continuous exposure to suffering can lead to compassion fatigue. Self-care helps nurses maintain empathy and compassion without becoming emotionally overwhelmed.
Promotes Longevity in the Profession: Sustainable self-care practices contribute to career longevity by helping nurses maintain enthusiasm and motivation over the long term.

By making self-care a priority, nurses can protect their health, sustain their passion for the profession, and continue to provide the best possible care for their patients.

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The Critical Role of Nurses in Healthcare

sites@tailorbrands.com — Sun, 30 Mar 2025 09:32:19 GMT

Nurses are the backbone of the healthcare system, contributing in ways that extend far beyond basic patient care. Here’s why nurses are essential to the success of healthcare:

Continuous Patient Care: Nurses provide 24/7 care, closely monitoring patients throughout their hospital stay. From assessing conditions to adjusting treatment plans, nurses are the consistent presence ensuring patients’ needs are met at all times.

Patient Advocates: Nurses play a crucial role as advocates, ensuring patients’ voices are heard. We work with families and other healthcare providers to make sure that patients' preferences and concerns are prioritized in their care.

Communication Experts: Nurses serve as a vital link between patients, physicians, and the healthcare team. We translate complex medical information into understandable terms for patients, ensuring they are informed and confident in their care decisions.
Holistic Care Providers: Nurses care for the whole person, addressing not only physical health but also emotional and psychological needs. We offer comfort and support, helping patients manage anxiety, fear, and stress during difficult times.

CRITICAL DECISION MAKERS

Nurses are often the first to notice subtle changes in a patient’s condition and make timely interventions to prevent complications. This quick decision-making can be life-saving in fast-paced healthcare settings.

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Improving Patient Safety: Best Practices for Nurses

sites@tailorbrands.com — Tue, 18 Mar 2025 09:32:19 GMT

Nicholas DeStefano BSN, RN, CNOR

Patient safety is a critical priority in healthcare, and nurses play a central role in ensuring that patients receive the best care possible. Nurses are often the first line of defense against potential errors and complications, making it essential to follow best practices that prioritize safety at every stage of patient care. Here are key strategies and practices nurses can adopt to enhance patient safety and improve outcomes.

Practicing Effective Communication

Clear and accurate communication is vital in preventing errors and misunderstandings. Nurses should:

STAY UPDATED ON POLICIES AND PROCEDURES

Healthcare is constantly evolving, and patient safety protocols may change over time, making it important for nurses to stay informed about updates in hospital policies, new safety protocols, and best practices. Nurses should actively participate in regular training sessions, simulations, or refresher courses on safety and patient care, and consistently follow evidence-based guidelines that have been proven to improve patient safety outcomes.

EDUCATE AND EMPOWER PATIENTS

Engaging patients in their care is a proven way to improve safety and outcomes. Nurses can help by:

01

Educate

Educating patients about their medications, treatments, and procedures

02

Encourage

Encouraging patients to ask questions and voice concerns.

03

Materials

Providing written instructions and teaching materials for home care and post-discharge follow-up.

Maintain Safe Environments

Keeping the patient’s environment safe reduces the risk of accidents and injuries.

Ensure that the patient’s bed rails are used appropriately, and that bed alarms are set for patients at risk of falls.
Regularly check that equipment is functioning properly and is stored safely.
Keep floors clear of hazards like wet spots or clutter that could lead to slips and falls.

PRACTICE ACCURATE DOCUMENTATION

Accurate and thorough documentation is crucial for continuity of care and patient safety. Nurses should:

Record all treatments, medications, and observations promptly and accurately.
Ensure that any changes in patient condition are documented and communicated to the healthcare team.
Double-check that documentation matches the treatment plan and that it’s updated in real-time.

Conclusion

Nurses are essential in maintaining and improving patient safety. By following these best practices—communicating effectively, practicing proper hand hygiene, verifying patient identity, preventing medication errors, educating patients, and staying informed on safety protocols—nurses can significantly reduce risks and enhance the overall quality of care. Patient safety is a shared responsibility, and by incorporating these practices into daily nursing routines, we can create a safer healthcare environment for everyone.

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23227108

AI Video Metrics Help Improve Operating Room Efficiency

Lead With Empathy Not Enforcment

AORN Clinical Improvement and Innovation

How One Hospital Stopped a Neurosurgical Infection Outbreak: Lessons from AORN 2025

�� The Problem: A Rise in Neurosurgical Infections

�� The Response: Building a Multidisciplinary Task Force

��‍⚕️ The Impact of a Surgical Infection Preventionist

�� Return on Investment: Quality and Cost Benefits

�� A Call to Action: Bring the Surgical IP to Your OR

The Importance of Self-Care for Nurses

BOOSTS PHYSICAL HEALTH

Follow Me!

The Critical Role of Nurses in Healthcare

Nurses are the backbone of the healthcare system, contributing in ways that extend far beyond basic patient care. Here’s why nurses are essential to the success of healthcare:

CRITICAL DECISION MAKERS

Follow Me!

Improving Patient Safety: Best Practices for Nurses

Nicholas DeStefano BSN, RN, CNOR

Practicing Effective Communication

STAY UPDATED ON POLICIES AND PROCEDURES

EDUCATE AND EMPOWER PATIENTS

Engaging patients in their care is a proven way to improve safety and outcomes. Nurses can help by:

01

Educate

02

Encourage

03

Materials

Maintain Safe Environments

PRACTICE ACCURATE DOCUMENTATION

﻿ Conclusion

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Conclusion