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Scientific Oral Presentation

Care Equity, Quality, and Safety

Operative Efficiency

Saturday, October 17, 2026
10:06 AM - 10:12 AM PT
Location: 406A

    Presenting Author(s)

  • SC

    Sivakumar Chinnadurai, MD, MPH

    Professor
    ENT and Facial Plastic Surgery, Children's Minnesota ; Department of Otolaryngology - Head and Neck Surgery, University of Minnesota
    Minnespolis, Minnesota, United States

    • Senior Author(s)

  • SC

    Sivakumar Chinnadurai, MD, MPH

    Professor
    ENT and Facial Plastic Surgery, Children's Minnesota ; Department of Otolaryngology - Head and Neck Surgery, University of Minnesota
    Minnespolis, Minnesota, United States

    • Co-Author(s)

  • Abby C. Meyer, MD, MPH

    Assistant Professor
    Childrens Minnesota
    Minneapolis, MN, United States

  • Brianne B. Roby, MD

    MD, FACS
    Children's Minnesota
    St. Paul, MN, United States

  • AJ

    Asitha Jayawardena, MD, MPH

    Associate Professor, Pediatric Otolaryngology
    Children's Minnesota
    Minneapolis, Minnesota, United States

  • AR

    Andrew J. Redmann, MD

    Assistant Professor
    Children's Minnesota/University of Minnesota
    Shoreview, MN, United States

  • EB

    Emily A. Bernardy, BSN, RN

    Surgery Center Manager
    Children's Minnesota, United States

Disclosure(s):
Abby C. Meyer, MD, MPH:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Andrew J. Redmann, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Perioperative inefficiencies during pediatric tonsillectomy and adenoidectomy (T&A) limit operating room throughput, restrict access to care and decrease patient and staff experience. Using data tracking and statistical process control (SPC) we aimed to improve perioperative efficiency by standardizing workflows across surgery, anesthesia, and nursing teams.

Methods: This prospective quality improvement initiative was conducted at an ambulatory surgical center within a pediatric health system participating in the Consortium for Improving Tonsillectomy & Adenoidectomy (CITA). Interventions targeted surgeon and anesthesia workflows for family discussions, consent, and order placement, nurse and technician driven room turnover. In-room preparation and turnover were monitored using SPC dashboards. Primary process measures included in-room time, patient preparation time and case turnover time. A secondary outcome was OR on-time performance - a surrogate marker for capacity creation. Data were collected from 1/25-12/25.

Results: Mean in-room time was 31.4 minutes. Mean in room patient preparation time decreased from 11.7 minutes to 11.1 minutes. Case turnover time, a team-based metric involving nursing, anesthesia, and surgical processes, decreased from 22.3 minutes to 18.5 minutes, representing the largest efficiency gain. On-time performance improved from -1.4 minutes at baseline to -7.7 minutes from the scheduled start time, indicating improved schedule reliability and creation of excess capacity. Improvements were sustained over the study period and continued to demonstrate month on month improvement as incremental efficiencies were created.

Conclusions: Participation in a multicenter, data-driven collaborative enabled rapid, sustainable improvements in perioperative efficiency for pediatric T&A. Standardizing surgeon, anesthesia, and nursing workflows using SPC reduced turnover time, improved throughput, and created additional case capacity demonstrating the value of multidisciplinary collaboration in creation of high-reliability surgical workflows.