Journal of spine surgery (Hong Kong) · 2026
Improving operating room turnover efficiency with a real-time workflow coordination software in adult degenerative spine surgery.
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Brumm Zachary G, Aepala Megha R, Gottlieb Justin K, Kim Paul D, Nigh Evan, Barrus Adam, Bowler Robyn, Britton Jodi, Bergen Sophea R, Haua Stephanie L, Makabenta Mary F, Pusch Sally, Stephens Susie, Fishell Josielyn, Iligan Hiedylyn, Airada Isabella, Tegura Vendellyn J, Ortega Vinalyn, Iniguez Kayla, Reyes Jessica, Iribe Nidya, Duda Brittany, Delos Santos Maria E, Raiszadeh Ramin
Аннотация
BACKGROUND: Operating room (OR) efficiency represents a critical determinant of surgical productivity, cost-effectiveness, workforce wellness, and patient access to care. Among its modifiable components, turnover time (TOT), the interval between patient exit and subsequent patient entry, is a key target for operational improvement. This study describes the impact of the S1 Pit Crew™ platform, a real-time, role-based OR workflow coordination software, on TOT using adult degenerative spine surgery as a representative test environment.
METHODS: This study examined prospectively collected perioperative and turnover workflow data from 51 consecutive elective adult degenerative spine surgery cases performed at a single hospital following S1 Pit Crew™ platform implementation. Baseline TOT was derived from institutional records of cases performed over the year preceding implementation and was used for descriptive comparison. The platform delivered real-time, role-specific task prompts and shared situational awareness across all perioperative team members via synchronized multi-device displays, enabling prospective collection of turnover and perioperative workflow data. A total of 24-time parameters were collected and aggregated into four key time interval durations including Stage 1: perioperative time interval #1 (dressing to wheels-out); Stage 2: turnover time (wheels-out to wheels-in); Stage 3: perioperative time interval #2 (wheels-in to incision); and total elapsed skin-to-skin time. Cases were stratified into initial (N=26) and subsequent (N=25) cohorts to assess efficiency with continued utilization and key time interval durations were also compared across procedure types, surgeon, OR, and case order.
RESULTS: Mean TOT was 26.5 minutes following platform implementation, compared with a baseline institutional average of 38.0 minutes, representing a 30.3% descriptive difference. TOT decreased significantly between the initial (28.9±7.7 minutes) and subsequent cohort (23.9±3.7 minutes) (P=0.02). Perioperative time intervals did not differ significantly between initial and subsequent cohorts (P>0.05). All key time interval durations were similar across procedure types, surgeons, ORs, and case order (P>0.05).
CONCLUSIONS: After implementation of the S1 Pit Crew™ platform, mean TOT was descriptively 30.3% lower than the prior institutional baseline, with improvement observed with continued utilization and similar time durations across procedure types of varying complexity. Through standardizing workflow with real-time, shared task visibility, the platform functions as a behavioral coordination tool while also promoting accountability and enabling identification of inefficiencies. Real-time workflow coordination through the S1 Pit Crew™ platform may represent a scalable approach to improving OR efficiency across surgical environments.
METHODS: This study examined prospectively collected perioperative and turnover workflow data from 51 consecutive elective adult degenerative spine surgery cases performed at a single hospital following S1 Pit Crew™ platform implementation. Baseline TOT was derived from institutional records of cases performed over the year preceding implementation and was used for descriptive comparison. The platform delivered real-time, role-specific task prompts and shared situational awareness across all perioperative team members via synchronized multi-device displays, enabling prospective collection of turnover and perioperative workflow data. A total of 24-time parameters were collected and aggregated into four key time interval durations including Stage 1: perioperative time interval #1 (dressing to wheels-out); Stage 2: turnover time (wheels-out to wheels-in); Stage 3: perioperative time interval #2 (wheels-in to incision); and total elapsed skin-to-skin time. Cases were stratified into initial (N=26) and subsequent (N=25) cohorts to assess efficiency with continued utilization and key time interval durations were also compared across procedure types, surgeon, OR, and case order.
RESULTS: Mean TOT was 26.5 minutes following platform implementation, compared with a baseline institutional average of 38.0 minutes, representing a 30.3% descriptive difference. TOT decreased significantly between the initial (28.9±7.7 minutes) and subsequent cohort (23.9±3.7 minutes) (P=0.02). Perioperative time intervals did not differ significantly between initial and subsequent cohorts (P>0.05). All key time interval durations were similar across procedure types, surgeons, ORs, and case order (P>0.05).
CONCLUSIONS: After implementation of the S1 Pit Crew™ platform, mean TOT was descriptively 30.3% lower than the prior institutional baseline, with improvement observed with continued utilization and similar time durations across procedure types of varying complexity. Through standardizing workflow with real-time, shared task visibility, the platform functions as a behavioral coordination tool while also promoting accountability and enabling identification of inefficiencies. Real-time workflow coordination through the S1 Pit Crew™ platform may represent a scalable approach to improving OR efficiency across surgical environments.