Sinai Hospital

Sinai Hospital

With the sponsorship of AORN (the Association of periOperative Registered Nurses), Leonardo Group Americas led a 5-day Kaizen Event at Sinai Hospital in Baltimore, with the goal of standardizing and optimizing changeover time in 24 OR suites.


Sinai Hospital in Baltimore, a LifeBridge Health hospital, was averaging 32 minutes from patient-out to patient-in in its 24 operating rooms. While this was considered good, the staff agreed that there was room to improve. More importantly, videos taken of the current OR suite changeover process revealed inconsistencies in the changeover process, that needed to be standardized further. Staff satisfaction was also expected to improve, once an improved process was implemented. The hospital selected the Kaizen approach to improvement, in order to quickly establish an improved OR changeover process, although they acknowledged that a roll-out to 24 suites would take additional time to complete.


Sinai turned to the Leonardo Group Americas as a partner in planning for and managing the Kaizen Event. Since only 5 days were allowed for the entire project, every day needed to be carefully choreographed, and the daily goals accomplished. The Kaizen approach assumes that the improvements will not only be identified and documented during the week, but they will also be implemented. The goal for this team was to document clearly the “Current State” of the changeover process, identify opportunities for improvement as a team, document the new suggested procedures, and roll them out to the staff in a controlled manner.

Leonardo Solution

The OR Changeover team’s approach was based on the Leonardo Group Americas' book Quick Changeover in the OR. One of the OR suites was made available to the team during the 5-day event, for the testing of the new changeover process. Extensive use of video, both of the Current State (taken ahead of time) and of the new process, allowed the team to fine-time and improve the process design. Six complete dry-runs of the procedure were conducted and recorded, and improvements were made after each iteration.

Lean Transformation

The OR Changeover team, nicknamed the Time Busters, knocked it out of the park. The OR changeover time dropped from an average of 32 minutes to 24 minutes, a 25% reduction. Staff satisfaction jumped from Moderate to High, based on a survey done a year earlier. The changeover process itself was fully standardized, including disinfectant solution exposure times. Training videos on the new procedure were created during the week. The potential benefit to the hospital, even if only 25% of the potential time savings were realized, approached $2,000,000. Not bad for a 5-day effort!