Several studies have shown that inefficiencies frequently arise outside the surgical procedure itself. Patient preparation, equipment setup, communication between team members, and room turnover often contribute more to total operating room time than the surgery alone. Improving these processes can increase surgical capacity without requiring surgeons to operate faster B49.
Where is time lost?
Studies analysing cataract surgery workflows demonstrate that perioperative processes account for a substantial proportion of total operating room time.
Common sources of delay include:
- patient positioning and preparation
- instrument setup
- microscope adjustment
- equipment preparation
- room turnover
- documentation
A prospective study evaluating cataract surgery workflows identified these perioperative milestones as key determinants of overall OR efficiency and suggested that optimizing them offers significant opportunities for improvement B49.
Standardization improves efficiency
One of the most consistent findings across surgical disciplines is that standardized workflows improve efficiency.
Reducing unnecessary variation allows surgical teams to anticipate each step, minimizes interruptions, and improves communication. In ophthalmology, targeted workflow interventions have been shown to reduce operating room turnover times by almost 46%, enabling more predictable scheduling and improved resource utilization B50.
Importantly, standardization is not about increasing speed—it is about reducing unnecessary delays.
Efficiency also benefits patients
Efficiency should never be confused with rushing. Well-organized operating rooms reduce stress for both surgeons and staff, shorten patient waiting times, and may increase the number of procedures performed without compromising quality.
Recent research comparing immediate sequential bilateral cataract surgery (ISBCS) with delayed sequential surgery demonstrated approximately 10% lower operating room utilization time, illustrating how optimized workflows can improve overall efficiency while maintaining clinical outcomes B51.
Training is an investment in efficiency
An efficient operating room begins long before the first incision. Simulation-based training enables surgeons to refine surgical techniques outside the operating room, reducing unnecessary movements and improving procedural confidence.
A multicentre clinical trial showed that proficiency-based virtual reality cataract training significantly improved operating room performance among novice and intermediate surgeons, demonstrating that structured training translates into measurable improvements during real surgery B52.