We applaud the endorsement of improving operating room (OR) throughput by a variety of means, including parallel processing. (“Improving OR throughput is not simply a buzzword of the year, but an actual possibility.”)1However, we wish to stress that parallel processing does not necessarily require an increase in personnel or additional facilities as stated in the editorial. Indeed, substantial reduction in nonoperative time can be achieved by reallocating responsibilities of the OR staff during the nonoperative interval. Specifically, the circulating nurse can remain in the OR to accelerate the setup for the next case; the anesthesiologist and certified registered nurse anesthetist can divide responsibilities: one may accompany the patient to the recovery area, while the other prepares for the next case; and the housekeeping staff can begin its work after the incision is closed while the patient is still in the OR.2Another low-cost solution, based on parallel processing is described by Cendan and Good.3Although more nonoperative time can be reduced by using some of the other measures suggested, “pure” parallel processing is considerably less expensive, and can thus be used by any hospital.

*Twin Peaks Group, LLC, Lexington, Massachusetts. dan-krupka@twin-peaks-group.com

Abouleish AE: Increasing Operating Room Throughput: Just Buzzwords for this Decade? Anesthesiology 2008; 109:3–4
Harders M, Malangoni MA, Weight S, Sidhu T: Improving operating room efficiency through process redesign. Surgery 2006; 140:509–16
Cendan JC, Good M: Interdisciplinary work flow assessment and redesign decreases operating room turnover time and allows for additional caseload. Arch Surg 2006; 141:65–9