ORbit Blog

Run your OR on data, not anecdotes

Plain-spoken, evidence-backed guides on OR efficiency and ASC operations — first-case on-time starts, turnover time, block utilization, cancellations, and the financial case behind them. Written for the people who run surgical days.

Start here — pillar guides

OR Efficiency·Pillar guide

First Case On-Time Starts (FCOTS): The Complete Guide

How FCOTS is defined, measured, gamed, and improved — and why your first case of the day quietly sets the ceiling for everything after it.

June 25, 2026·10 min read
OR Efficiency·Pillar guide

The OR Efficiency Metrics That Actually Matter

Most OR scorecards measure the wrong things. The perioperative KPIs that hold up, the vanity metrics to ignore, and how to keep them honest enough that surgeons trust them.

June 24, 2026·9 min read
ASC Operations·Pillar guide

Outpatient Total Joint Arthroplasty: The Shift to the ASC

Total joints are leaving the hospital. What is driving the move to the ASC, what the outcomes data actually shows, and why efficiency becomes the survival lever.

June 23, 2026·9 min read

Understand the metrics

Definitions and benchmarks for the numbers that actually predict OR efficiency.

Block Scheduling

Block Time Utilization Explained: Adjusted vs. Raw

Raw vs. adjusted utilization tell different stories — and neither should allocate OR time on its own. A plain-English guide with a worked example.

June 26, 2026·3 min read
Cost & Margin

The Real Cost of One Operating Room Minute

OR time is expensive — but how expensive, exactly? The per-minute numbers, and the four places they leak out, in real dollars.

June 26, 2026·3 min read
OR Efficiency

OR Turnover Time: Benchmarks and What "Good" Looks Like

There is no official national turnover benchmark — and the number you report depends entirely on how you define it. Here is how to set a target you can defend.

June 26, 2026·3 min read

Improve your OR

Evidence-backed playbooks for moving each lever — starts, turnover, blocks, cancellations.

Scheduling

AI and Predictive Analytics in OR Scheduling: Hype vs. Help

A clear-eyed read on AI in OR scheduling: the applications that genuinely help, the tradeoffs vendors gloss over, and what to ask before you believe the demo.

June 26, 2026·3 min read
OR Efficiency

First-Case Delays vs. Turnover Time: Where to Focus First

You can’t fix everything at once. A simple decision tree for whether to attack first-case starts or turnover time first.

June 26, 2026·3 min read
OR Efficiency

How to Improve First Case On-Time Starts in Your OR

Diagnosis before exhortation. The three interventions that actually move first-case starts — and how to know which one your OR needs.

June 26, 2026·4 min read
OR Operations

Building an OR Day Board: What to Track in Real Time

Reporting tells you what already went wrong. A day board lets you change today. The real-time signals worth surfacing — designed for the charge nurse, not the spreadsheet.

June 26, 2026·3 min read
Block Scheduling

How to Reclaim Underutilized Block Time

Unfilled blocks quietly cap your case volume. How to set an honest release threshold and have the surgeon conversation with data, not opinion.

June 26, 2026·3 min read
OR Efficiency

How to Reduce Day-of-Surgery Cancellations

Most cancellations come from a handful of fixable causes. The pre-op, clearance, and communication gates that prevent them — and the taxonomy that keeps you honest.

June 26, 2026·3 min read
OR Efficiency

How to Reduce OR Turnover Time Without Burning Out Staff

You cannot cut turnover by telling people to hurry. The parallel-processing and pit-crew moves that actually work — with the QI numbers behind them.

June 26, 2026·3 min read
Cost & Margin

Surgeon Preference Cards Are Draining Your Supply Budget

Preference cards rot quietly — and opened-but-unused supplies add up fast. The verified cost of the waste, and the data-driven way to cut it.

June 26, 2026·3 min read
Scheduling

Why Your Scheduled Case Times Are Wrong (and How to Fix It)

Bad booked times quietly sabotage the whole day. Why surgeon estimates drift — and why good history beats both guesses and, often, a fancy model.

June 26, 2026·3 min read

Build the case

The cost math and buyer’s view for surgery-center leaders making the call.

ASC Operations

ASC Economics: Why Total Joints Are Moving to Surgery Centers

Total joints save the system real money in the ASC — but per-case reimbursement is falling. Here is why efficiency, not the contract, is where ASC margin now lives.

June 26, 2026·3 min read
ASC Operations

Are ASCs Safe for Total Joints? What the Outcomes Data Shows

Registry data shows low readmission and ER rates for ASC total joints — but the headline hides a selection story every program needs to understand.

June 26, 2026·3 min read
Buyer's Guide

How to Choose OR Analytics Software for Your Surgery Center

A practical buyer’s guide: the must-have capabilities, the integration questions that separate real tools from dashboards, and the adoption red flags to watch.

June 26, 2026·3 min read
Cost & Margin

The Hidden Cost of Same-Day Surgical Cancellations

Most day-of-surgery cancellations are avoidable, and each one strands staffed OR time you cannot get back. What the data says about how often, and how much.

June 26, 2026·3 min read
Capacity & Throughput

Lost-Case Scoring: Quantifying the Cases You Leave on the Table

The case you did not do is invisible — until you measure it. How lost-case scoring turns scattered wasted minutes into "cases left on the table."

June 26, 2026·3 min read