Improve Operating Room Efficiency; Save $1M

The Opportunity

Adventist Health White Memorial (AHWM) is the region’s leading faith-based, nonprofit teaching hospital. Nestled in the heart of downtown Los Angeles, the hospital performed over 5,900 surgeries in 2018 in their 6 main operating rooms.

The mean cost of operating room (OR) time is estimated at $41/minute in 2018 and every minute wasted at AHWM creates the potential for operational and fiscal waste. To manage the turnaround steps that occur when a patient surgery completes and is wheeled out to the post-anesthesia care unit (PACU), departmental leaders relied heavily on manual data collection and communication between their clinical and ancillary teams.

Hospital leaders identified a particular challenge with the Environmental Services (EVS) function, estimating it would take up to 15 minutes to relay information that a soiled OR suite was empty and ready for cleanup. AHWM recognized the EVS function as particularly critical to prompt turnaround times.

The tasks and functions of ancillary teams are often an afterthought in operating room efficiency, when in fact, they are essential for effective patient throughput and turnaround times. When all required staff, equipment, and patients are not where they should be at the right moment, quality and costs suffer, and performance suffers.

Prior to implementing the TAGNOS OR Patient Flow Solution, staff at AHWM had no way to automatically capture and share critical movements, like patient wheels in (WI) and patient wheels out (WO).

They were reliant on timestamps that were manually inputted by clinical teams. Accuracy and timeliness of these manual inputs were not a focus, and ancillary teams had no visibility into patient statuses to prepare their workloads.

Oftentimes, it would take up to 15 minutes to simply alert EVS teams on WO, which created delays for subsequent case starts and snowballed into staff overtime.

Key Details

  • Large Metropolitan Hospital
  • High volume of patients
  • Procedure rooms underutilized by 40%
  • Slow communication between teams
  • Delays in EVS response time
  • Inefficient manual data capture
  • Inefficient use of staffing hours
  • Decreasing revenues

The Solution

To enable all team members to work in sync, staff was equipped with Zebra-TC Series Touch Computers to receive real-time access to TAGNOS data about each patient’s location and movements inside and outside the OR. TAGNOS’s interoperability with IoT infrastructure automatically collects the location and status of patients via an active RFID-enabled wristband assigned at check-in. In addition, the Zebra-TC Series Touch Computers host an active RFID chip that allows for visibility of staff at critical check-points. 

With the TAGNOS solution deployed, staff automatically receives actionable, real-time data as each patient is wheeled in and wheeled out of the OR. As a result, Operating Room Nurses, Anesthesia Technicians, and EVS were empowered with shared communications across 6 operating rooms.

As a patient enters a specific OR, an automated alert is triggered communicating actual surgery start time to all staff roles associated with that room. For the EVS team, patient entry alerts offer actual time-stamped surgery start times, so they can plan their workflows accordingly. Finally, notification of patient’s WO (exit) from the room triggers an automated alert the patient is being moved out and the room is ready for clean-up. 

The TAGNOS system automatically captures both the in and out time of EVS via the touch computer. This provides leadership insight into EVS movements and captures the actual time it takes to clean a room (unavailable prior to TAGNOS).

The Results

Automated clinical workflows triggered by real-time location system (RTLS) alerts from TAGNOS and mobile communication with Zebra-TC Series Touch Computers creates a highly synergistic and efficient surgical suite that illuminates actionable information and orchestrates open lines of communication. 

This cost reduction breaks down to almost $82,000 per month, or $162,000 for each OR suite annually assuming at least a 3-minute reduction. Streamlining the efforts of EVS and its ‘speed to room’ allows the team to end the day on time and prevents additional use of labor and facility resources, such as overtime charges. Here is a list of significant results provided by OR Orchestration


Room Turnover


Housekeeping “Time to Room”


Anesthesia Tech Response Time Increase


EVS “Time to Room” Decrease




Annual Cost Savings in OR Turnover

In addition to the above benefits, a Turnaround Technician with TAGNOS phone was added to facilitate setup and additional support during turnaround.

The solution yielded some intangible benefits, as well: 

  • Role-based communication at an OR suite level ensured all relevant staff members are communicating within one, accurate message loop. 
  • Receiving the same information improved communication and gave teams a stronger perspective on how interrelated their tasks are. 
  • Staff members feel they are in a better position to schedule their time around surgical activity. It has fostered a high level of teamwork since the ambiguity and burden of communicating simple, yet vital information is completed automatically for them. 

In summary, TAGNOS’ solution automatically illuminated and delivered vital patient flow information into the hands of clinical and ancillary team members that improved efficiencies, outcomes, and the patient experience.

About the Author

Erik Davidson

Putting customers at the heart of TAGNOS

Erik serves TAGNOS as its Chief Customer Officer. He is responsible for keeping customers at the heart of the TAGNOS mission by leading Sales, Marketing, Customer Success, and Product Strategy initiatives. Erik has a breadth of entrepreneurial experience that includes being a founder, employee, advisor, and investor in a variety of new ventures. Complimenting his entrepreneurial experience, he has also been hired to serve in leadership roles at established businesses ranging from managing functional departments to growing the organization as the CEO. Erik is actively involved in his community and serves in part-time public office.  When he isn’t working, he is cherishing time with his loving family, teaching Taekwon-Do, spending time outside, reading, learning, or simply enjoying life.

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