Through the implementation of this project, all stages of the surgical process were made transparent and analyzed in an objective manner, allowing the surgical unit board to implement actions to improve performance based on evidence, instead of "personal beliefs".
The KPIs that have been computed from the dataset available from the tracking system were presented by the surgical unit board to the different department directors, and this facilitated improvements of surgical team performance.
Maintaining the same level of complexity of surgical procedures performed, evidence shows the following performance improvements, in terms of both efficiency and effectiveness (data before 2009, and thus full comparisons between ex-ante and current situations, are not available since this information can only be calculated thanks to the new information system):
 Rate of operating room occupancy: from 71% in 2009 to 79% in 2010, i.e. +11% or +401 surgical procedures
 Number of unscheduled procedures: from 25% to 16%, i.e. -36% (in operating rooms the clinical risk for the patient is always very high and the first rule to decrease is to increase the level of standardization of the process; when the surgical team works in an unscheduled way there is a lower level of standardization and thus the clinical risk increases)
 Over-time working hours expenditure: € 524,000 in 2009 to € 497,000 in 2010, i.e. -21%
 Patient’s safety: no wrong surgery or near misses from 2009 so far.
The system also allows to benchmark against other “scientific” indicators. In the scientific literature, there are a few important efficiency indicators to evaluate the operating room performance, which have been computed for the Forlì Hospital:
 Turnover-time (delay from the scheduled time to end the surgery of the last procedures of the day and the real time)
- 2009 (mean ± standard deviation): 30 ± 20 min
- 2010: 32 ± 21
 Over-time (time for cleaning and setting up of the operating room between two patients – benchmark in literature is 25 min)
- 2009: 80 ± 59 min
- 2010: 77 ± 54
Generally speaking, this project demonstrates that a good idea doesn’t depend on money, it depends on people. A good team is made by different people who are able to share their knowledge for a common goal.
We started from the simple data but as secondary effect we arrived to the culture; this system was able to create a new way of communication among all the people involved and at different levels of management it was able to improve the quality and safety of the operating room activity.
If we think about the operating room block as a car we learnt that it is not important how fast it goes but it is the average speed that makes the difference; Moreover we understood that all the variables involved in the operating room management are well controlled now and the level of risk either for the patient or the team is reduced.