Closing Keynote: Trimming the Sails: Improving Perioperative Efficiency by Managing Same-Day Admission Transitions

Editor's Note

Attendees to the 2025 OR Business Management Conference gained new insight with an international flavor from Moustafa Bleik and Fadi Fares, who had flown all the way from Saudi Arabia to detail recent improvements at King Faisal Specialist Hospital and Research Center. In a session with multiple audience polls and even a skit, Bleik, manager of OR scheduling and data management, and Fares, manager of the day surgery unit and PACU, detailed how overhauling scheduling, discharging ad bed-management strategies helped enhance efficiency and improve patient flow by streamlining same-day admission transitions.

The transition comes as the hospital undergoes a transformation from a fully funded government entity to a not-for-profit model, Fares and Bleik reported. As a result, financial sustainability through increased efficiency and strategic insurance partnerships became a key priority. A key focus was minimizing inpatient admissions while expanding same-day surgical procedures, a shift that has yielded measurable improvements.

As described by the presenters, previous challenges included an inefficient discharge process and limited bed availability, which led to operational bottlenecks, extended patient waiting times, and surgical delays. A surge in emergency department admissions further exacerbated congestion. Staff shortages, poor communication, and slow turnover of postoperative beds also strained resources, reducing both patient and staff satisfaction. Additionally, prolonged preoperative times and coordination gaps between teams increased the risk of postponed surgeries and scheduling disruptions.

One intervention to address these challenges was finalizing the surgical schedule two days in advance to improve bed planning and reduce last-minute conflicts. Another was engaging physicians to conduct early rounds and confirm discharges sooner to speed patient turnover. The presenters also discussed how mandating preoperative clinics for patients reduced delays by ensuring completion of tests, consent forms, and other necessities prior to the day of surgery.

A particularly impactful change was the introduction of a centralized “command center” where live dashboards monitor patient flow in real time. For example, the presenters described how automated alerts notified teams when patients were delayed due to uncompleted discharge paperwork or unavailable postoperative beds, triggering immediate escalation to department leaders.

Among other results of these efforts, same-day admissions reportedly increased from an average of three patients per day to 30, significantly reducing the need for overnight stays, the presenters reported. The median postoperative wait time for bed assignment decreased from four and a half hours to just over 30 minutes. Additionally, operating room utilization rates improved, cancellations dropped, and overall patient throughput increased.