Making the OR More Efficient, for Patients and Staff
From left: Abbe Craven, MD, Amanda Rhee, MD, and Jeanne Chang, MS, RN, viewing a readiness board, which tracks the status of operating rooms and surgical patients.
When patients arrive for surgery, it is often very early in the morning, they have been fasting for hours, and they are probably a bit anxious about what is to happen. An important part of their care is ensuring a smooth and efficient experience.
To achieve this goal, the One OR initiative was created. After safety and providing high-quality patient care—which always come first—operating room efficiency is a top priority, with the goal of preventing delays, optimizing scheduling, and providing the best possible experience for patients and staff.
The initiative is led by Amanda Rhee, MD, Vice President of Perioperative and Procedural Services for the Mount Sinai Health System, and since the beginning of 2025 it has taken a system-level approach, focused on coordination and communication. This includes tracking on-time starts, room turnover, and case cancellations—all factors that shape patients’ experience before, during, and after surgery.
The Challenge: Optimizing the use of ORs
For Dr. Rhee, efficiency is inseparable from both patient care and staff well-being. “When we run safely and efficiently, we can take better care of patients and support our teams at the same time—making it possible for clinical teams to do their work well and get home to their families as soon as they can,” she says.
The One OR effort is bringing people together across hospitals and disciplines to solve shared challenges and strengthen care delivery. The teams have found opportunities for improvement, including this one:
Across Mount Sinai’s operating rooms, surgical time was not always easy to share. When surgeons didn’t need a scheduled block—because a case changed or a day shifted—there wasn’t a simple, systemwide way for others to see or use that open time. This sometimes led to delays, rescheduling, and longer waits for patients.
To make block time easier to share, Mount Sinai introduced Epic OR Marketplace, a platform that gives surgeons insight into operating room availability, so they can reserve empty blocks of time or release time they do not need. Filling blocks of time more efficiently has reduced delays and last-minute changes, helping patients access needed surgeries more easily and supporting safer, more predictable care. It is surgeons helping other surgeons have access to time in the OR.
The One OR initiative spans Mount Sinai’s complex perioperative environment, across
seven hospitals and two ambulatory surgical centers, with 145 main operating rooms and 20 endoscopy suites, serving more than120,000 patients a year. The initiative has established systemwide governance bodies to guide perioperative operations and align priorities across sites and hospital-based committees.
The Solution: Tech, Training, and Teamwork
One of these groups is the System Committee for OR and Procedural Upgrades and Technology, co-led by Jeanne Chang, MS, RN, Director of Procedural Clinical Technology, and Abbe Craven, MD, Director in Clinical Informatics. As a nurse-physician informatics team, they translate front-line needs into practical solutions, informed by input from surgeons, anesthesiologists, nurses, technicians, sterile processing, and preoperative and registration teams. “The OR Marketplace stemmed from this committee, and it was effective because many teams across the OR arena collaborated to bring this useful tool to life,” Dr. Rhee says.
“When we began talking with teams about new tools, the floodgates opened,” Dr. Craven says. “People started pointing out opportunities for improvement that hadn’t been visible before. Introducing one solution helped us recognize other places where technology could better support care teams.”
The improvements are measurable. In 2025, Mount Sinai recorded 600 fewer hours of delays in getting first cases started, compared with 2024, along with 1,040 fewer case cancellations, and 4,900 additional block hours released.
For Ms. Chang, the changes have been especially meaningful for patients. “Anything we can do to reduce delays and uncertainty makes a difference for patients, especially those who have been fasting for hours and are anxiously awaiting their procedure,” she says. “When teams are aligned and ready, it improves the experience for everyone.”
Dr. Rhee credits the progress to trust, partnership, and shared ownership across the Health System. “None of this happens without collaboration,” she says. “There are many teams and leaders working together to improve the ORs and endoscopy suites in a variety of ways. The reason we’ve been able to achieve so much is because people believed we could do it together. And we are just getting started.”
We are Mount Sinai, making operating rooms run more smoothly.