One Dedicated Operating Room Team Member Improves Total Joint Arthroplasty Efficiency

Background Variable operating room (OR) staffing reduces efficiency in total joint arthroplasty (TJA). Prior studies show consistent OR teams improve efficiency; however, the impact of a single dedicated team member (DTM) in variable staffing settings is unknown and may be more achievable for a given surgeon. This study evaluated the impact of adding a DTM on OR efficiency and cost. Methods We conducted a single-group pre-post study at a high-volume academic hospital, comparing outcomes for cases performed by a single adult reconstruction surgeon over two periods: six months before and eight months (excluding a three-month learning curve) after adding a nurse practitioner as a DTM. Primary total knee arthroplasty (TKA) and posterior-approach total hip arthroplasty (THA) cases were included, using consistent surgical technique and implants. Outcomes included OR time, turnover time, total supply costs, wasted supply costs, and case volumes. Based on prior literature, OR time costs $46/minute. Differences were analyzed using a t-test. Results For TKA (n=145), adding a DTM significantly reduced OR time by 18.2 minutes, turnover time by 15.1 minutes, and total supply costs by $243. For THA (n=92), OR time significantly decreased by 16.5 minutes, turnover time by 18.6 minutes, and total supply costs by $393. Wasted supply costs showed no significant difference for TKA and THA. Combined OR and turnover times significantly decreased by 33.3 minutes per TKA and 35.1 minutes per THA, with supply cost reductions of $243 and $393, respectively. This equated to a cost savings of $1,080/TKA and $1,152/THA. Case volumes per day significantly increased after the introduction of a DTM. Conclusions At our institution, a single DTM significantly improves OR efficiency and reduces costs in TJA, supporting the adoption of dedicated staff in academic ORs. As reimbursements decline and demand for volumes rises, health systems should prioritize consistent OR staffing.