To map strategies, technologies and management practices reported in the literature that contribute to improving operational efficiency in operating theatres.
Method:
A scoping review conducted according to the Joanna Briggs Institute methodology and reported following the PRISMA Extension for Scoping Reviews (PRISMA-ScR). Searches were conducted in March 2025 in PubMed, ScienceDirect, Scopus, Embase, CINAHL and the Virtual Health Library, as well as grey literature sources including Google Scholar and the CAPES. Studies published within the last 5 years addressing technologies to improve operational efficiency were included.
Results:
Fifteen studies were included (11 articles and 4 theses/dissertations), most of which were conducted in the United States (40%). Identified strategies included Lean Six Sigma, scheduling automation, digital communication platforms and artificial intelligence, demonstrating improvements in indicators such as turnover time, surgical delays and theatre room idle time.
Conclusion:
Technological and process-improvement strategies show potential to optimise operating theatre performance and support safer, more efficient use of health care resources.
AtkinsBBraunCBromwellR, et al2024Operating room throughput efficiency improvement at LewisGale Medical Center, Salem VA In: 2024 Systems and information engineering design symposium (SIEDS), Charlottesville, VA, 3 May pp 397–402New York, IEEE
2.
BelliniVRussoMDomenichettiT, et al2024Artificial intelligence in operating room managementJournal of Medical Systems48 (1) 19
3.
ChenXHeJPengL, et al2024Impact of a task-grabbing system for surgical technicians on operating room efficiencyScientific Reports14 (1) 4296
4.
CohenTNKanjiFFZamudioJ, et al2024Why can’t we improve turnover time? A systematic reviewWorld Journal of Surgery48 (1) 72–85
5.
CupplesADuvaIBirdsongH, et al2025Surgical turnover time using lean six sigmaJAMA Surgery160 (3) 352–354
6.
EspaillatA2024Enhancing operating room surgical efficiency through artificial intelligence: a comprehensive reviewSurgical Research6 (4) 1–8
7.
FyntikisAM2024Assessing the efficiency of a large university hospital’s operating room planningEnschede, University of Twente
8.
GazzarataRAlmeidaJLindsköldL, et al2024HL7 fast healthcare interoperability resources in digital healthcare ecosystems for chronic disease management: scoping reviewInternational Journal of Medical Informatics189 105507
9.
GomesJAMartinsMMTronchinDMR, et al2021Quality assessment of the surgery center regarding structure, process and resultsCogitare Enfermagem26 e71083
10.
Joanna Briggs Institute2015JBI reviewers’ manual: methodology for JBI scoping reviewsAdelaide, SA, The Joanna Briggs Institute
11.
KaneWJShillingAMSchroenAT2021A surgeon badge or text message sign-in intervention improves operating room start efficiencyJournal of Surgical Research264129–137
12.
KellyJTCampbellKLGongE, et al2020The internet of things: impact and implications for health care deliveryJournal of Medical Internet Research22 (11) e20135
13.
KravitzM2022Comparative analysis of the leading methods for optimizing operating room efficiency and cost effectivenessPittsburgh, PA, University of Pittsburgh
14.
KubalaMGardnerJRCriddleJ, et al2021Process improvement strategy to implement an outpatient surgery centre efficiency model in an academic inpatient settingInternational Journal of Pediatric Otorhinolaryngology144 110650
15.
MacMillanLMaduraGMElliotM, et al2025What affects operating room turnover time? A systematic review and mapping of the evidenceSurgery181 109263
16.
McleodRMyint-WilksLDaviesSE, et al2021The impact of noise in the operating theatre: a review of the evidenceAnnals of the Royal College of Surgeons of England103 (2) 83–87
17.
MichelinLRicciBBarbagalloV, et al2021Can operating room efficiency be increased by applying the lean six sigma models?Archives of Clinical and Medical Case Reports5 (4) 549–558
18.
MitchellCVAndersonARRomitoK, et al2025Employing lean six sigma strategies to improve operating room first case on-time starts: a case reportPerioperative Care and Operating Room Management38 100473
19.
OnishiTCasanovaC2024Research on the efficiency of operating room management through numerical optimization and matters to be considered in the process In: IEEE computers, software, and applications conference, Osaka, Japan, 2–4 July pp 1961–1964New York, IEEE
20.
ParikhNGargolloPGranbergC2021Improving operating room efficiency using the six sigma methodologyUrology154141–147
21.
PasquerADucarrozSLifanteJC, et al2024Operating room organization and surgical performance: a systematic reviewPatient Safety in Surgery185
22.
PollockDPetersMDJKhalilH, et al2023Recommendations for the extraction, analysis and presentation of results in scoping reviewsJBI Evidence Synthesis21 (3) 520–532
23.
RamadanSAbu-ShamsMAl-DahidiS, et al2025A data-driven approach for predicting remaining intra-surgical time and enhancing operating room efficiencyJournal of Industrial Engineering and Management18 (1) 145–166
24.
RochaSL2021Efficiency and productivity of the operating room: importance of the support team to optimize operating room turnoverSão Paulo, Fundação Getúlio Vargas
25.
SchoutenAMFlipseSMvan NieuwenhuizenKE, et al2023Operating room performance optimization metrics: a systematic reviewJournal of Medical Systems47 (1) 19
26.
SinghDCaiLWattD, et al2023Improving operating room efficiency through reducing first start delays in an academic centreJournal of Healthcare Quality45 (5) 308–313
27.
SlagermanS2021Improving healthcare and operating room efficiency using lean six sigmaWinnipeg, MB, Canada, University of Manitoba
28.
SrinivasSYoungAJ2023Machine learning and artificial intelligence in surgical researchSurgical Clinics of North America103 (2) 299–316
29.
StuckyCHKaboFWDe JongMJ, et al2024Surgical control time estimation variability: implications for medical systems and the future integration of AI and ML modelsPerioperative Care and Operating Room Management37 100432
30.
TjugumVKolstadLRLarsenMH, et al2026Psychosocial factors that influence occupational stress in operating room nurses’ working environment: a scoping reviewWorkplace Health and Safety74 (3) 107–123
31.
VladuAGhiteaTCDainaLG, et al2024Enhancing operating room efficiency: the impact of computational algorithms on surgical scheduling and team dynamicsHealthcare12 (19) 1906
32.
WoelfelIWangTPieperH, et al2023Distortions in the balance between teaching and efficiency in the operating roomJournal of Surgical Research283110–117
33.
ZadehHSZhangLFackrellM, et al2025Advanced forecasting of emergency surgical case arrivals: enhancing operating room performancePerioperative Care and Operating Room Management38 100451
