How to cite: Parker SY. Optimizing O.R. time: team-based strategies for surgeons and APPs. Grand Rounds in Urology. October 2025. Accessed Jan 2026. https://grandroundsinurology.com/optimizing-o-r-time-team-based-strategies-for-surgeons-and-apps/
Summary
This presentation outlines team-based strategies to improve operating room efficiency by addressing workflow barriers, communication gaps, and preparation challenges across the perioperative pathway. Sarah Y. Parker, MSN, AGNP-C, Nurse Practitioner, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, reviews common operating room inefficiencies, including delayed case starts, room turnover delays, unfamiliarity with case requirements, sterile processing challenges, communication breakdowns among disciplines, role confusion, provider overwhelm, and patient-related barriers such as limited health literacy.
Core components of effective operating room teams are defined, emphasizing clear and consistent communication, standardized terminology, defined roles, mutual respect, shared goals, and situational awareness. Parker highlights the importance of repetition, consistency, and training to improve coordination and reduce errors, delays, and cancellations.
The presentation discusses the value of automation and standardization in preoperative workflows, including standardized risk assessments, ASA scoring, medication and condition screening, hard-stop protocols, and consistent preoperative patient education. Video education, printed step-by-step materials, expectation setting, and scheduled reminder calls are described as tools to improve patient preparedness and reduce same-day cancellations.
Preoperative preparation strategies include reviewing surgical cases 10 to 14 days in advance and proactively addressing logistical factors such as transportation, social support, dialysis scheduling, medication management, and discharge planning. Collaboration with preoperative nursing teams and anesthesia is emphasized through standardized protocols, anticipation of clinical needs, and timely communication.
Operating room leadership and team investment are discussed, focusing on education, coaching, and understanding how team members learn best. Postoperative workflow optimization addresses early disposition planning, streamlined documentation, dynamic order sets, and proactive patient communication to reduce unnecessary resource utilization. The presentation concludes with an emphasis on self-reflection using operating room metrics, patient satisfaction data, and postoperative outcomes to identify opportunities for improvement.
About The 12th Urology Today Conference:
Presented by chair Ryan P. Terlecki, MD, FACS, the 12th Urology Today conference was designed to keep urologists, urologic oncologists, and other healthcare providers educated on the most pertinent issues in urology practices. Areas of focus included urologic oncology, men’s health and reconstruction, female urology, pediatric urology, kidney stones and related conditions, and methods of providing the best care amidst the required logistics of the business side of medicine.
