SS288 EC161531 Nurse Exec Landing Page Banner

At Halyard Health, we’re excited to continue our legacy of partnership with hospitals and healthcare professionals to move Care Forward. That’s why we’re once again sponsoring the AORN Nurse Executive Leadership Series (NELS) for 2018. Together, AORN and Halyard are committed to professional development opportunities for perioperative nurses to promote patient safety and optimal OR outcomes.

We look forward to meeting with many of you at upcoming NELS events around the country!

Also in 2018:

Lose your Margin in an OR Minute! 

How Surgical Delays Affect the Bottom Line

OR time delays are critical to the profitability of each patient case. Taken together, seemingly small delays can result in profit erosion for your entire hospital. Implementing small changes to avoid or eliminate delays can have a direct and positive impact on your bottom line.

The Economics of OR Margin

Nels QuoteApproximately 65% of all hospital admissions are due to surgical interventions and account for more than 40% of the total expenses of a hospital.2 Each surgical facility needs a clear understanding of its economic structure to establish the groundwork for an efficient and well-functioning OR suite.  Underlying the concern for the cost of OR time is another issue: “How much money is being lost through delays?”.3

In today’s climate of Value-based Reimbursement, providers’ payments are based on the “value of care” delivered to treat a patient during a specific episode of care. Your hospital’s overall financial success now depends on cost containment to protect margins while delivering the best patient experience possible. Understanding and mitigating “cost leaks” in your OR is a high-return place to start. 

Non-profit Total Knee Replacements?

Are you giving away your profits through time delays in the most valuable real estate in your hospital?

The impact on margin will vary greatly depending on each facility’s specific costs, charges, and reimbursement, but when you consider that over 61%2 of all surgical procedures experience a delay, you may be essentially giving away your profit margin without realizing it. 

Let’s look at an inpatient total knee replacement without major complications. If, for example, yours is one of the many hospitals participating in Medicare’s Comprehensive Care for Joint Replacement (CCJR) bundled payment model, your Medicare payment for the complete bundle of care could range from $18,000 to $33,000.4

Using an average Medicare payment of $25,5005 and applying an historical average hospital operating margin of 6%6 would yield approximately $1,530 of profit per episode: 

Sample Medicare payment


Aggregate profit margin possible based on national sample of hospitals (6% of $25,500)6


Average cost per OR minute3


Average cost of an OR delay (8 minutes @ $62)


Number of minor delays (8 min each) to erase the margin of one procedure ($1,530 ÷ $496=3.08)



For every 3 procedures with a delay, you're giving one away at cost!

How can we minimize OR delays and regain profit margin?

There are always challenges to running a busy OR, so seemingly small delays can be dismissed as being the normal course of cases, or you can look at any delay as an opportunity to improve.

Take Steps to Reduce Delays and Protect Margins in Each Surgical Procedure

  1. Document your delays to understand root causes, and analyze trends.
  2. Calculate your costs per procedure.
  3. Identify your facility’s current margins by procedure.
  4. Understand the top delays for each procedure and the time lost per delay.
  5. Review product selection and workflow, including asset tracking and staff tracking.
  6. Identify areas for improvement and implement an action plan for each.
  7. Set a measurable goal to improve margins for each procedure and monitor progress.
  8. Involve everyone and communicate successes!

Small Changes, Big Impact

At an average of $62 per minute3, even small delays can add up quickly. Yet many common delays in the OR can be minimized with simple changes. Halyard suggests some ways you can address these “pain points” in three categories:


Pain Point: Strikethrough on gowns or face masks resulting from wearing the wrong protection-level for the procedure.         

Time Impact: 10 - 15 Minutes to break scrub, re-scrub, replace mask, re-gown and re-glove.   
Cost of Delay: $620 - $930                           

Halyard Solution: With AERO SERIES* gowns from Halyard, the color difference makes it easy to choose between AAMI Level 3 protection (for most procedures) and AAMI Level 4 for longer, high-fluid procedures. Similarly, FLUIDSHIELD* ASTM-rated surgical masks help wearers choose the appropriate level of facial protection.

Pain Point: Tears in sterilization wrap or damaged instrument containers that require replacement sets or re-sterilization.

Time Impact: 8 - 60 Minutes for flash sterilization or up to an hour to obtain a terminally-sterilized replacement set.

Cost of Delay:    $496 - $3,720

Halyard Solution: SMART-FOLD* Sterilization wrap is 61% heavier, with reinforced zones around tray corners and edges.



Pain Point:  Critical equipment or implants not ready or not available to start the procedure.       

Time Impact: 10 Minutes to hours to locate and prep required equipment.          

Cost of Delay: $620 - $$$$           

Halyard Solution: AiRISTA® Equipment tracking and monitoring systems let you easily locate critical products and equipment to be sure they arrive at the OR when needed.



Pain Point: Surgical team members or patients are not ready, not available or need to leave during the procedure. Work will stop (or not start) until the team is complete and ready.

Time impact: 10 Minutes to hours           

Cost of delay: $620 - $$$$

Halyard Solution: AiRISTA® Staff and patient tracking systems tell you where your patient and OR team members are (and where they’re scheduled to be) so that you can confidently plan for each procedure.             


REMEMBER: Every minute counts and it only takes an OR Minute to Lose Your Margin! 

Addressing OR delays is one of the more productive opportunities to decrease costs and increase profits in your facility. Contact your Halyard representative for assistance in developing OR time savings solutions that fit your OR. For more information on Halyard surgical products and technologies go to:    www.halyardhealth.com/surgicalsolutions



"Innovation, Optimization, and Transformation in the Perioperative Setting"

Join with OR and SPD Professionals and management peers to learn about the transformation occurring in healthcare, the importance of innovation in developing a better patient experience, and tools to help eliminate inefficiencies that cause frustrations for the healthcare provider.  Includes accredited education content:

Spend a day to learn what's next. 

Click here to sign up for an upcoming AORN NELS Workshop near you! We are especially excited to once again welcome Atlanta-area attendees to the Aptil 24th NELS event hosted at Halyard Health headquarters! 

April 17th in Dallas
April 19th in Philadelphia
April 24th in Atlanta
April 26th in San Jose
May 3rd in Chicago
May 8th in Newark
May 10th in Cincinnati
May 15th in Houston
May 17th in Baltimore
May 24th in Seattle

In 2018, Halyard will once again “Double Your Donation” during the AORN Matching Gifts campaign. In November and December 2017, the Matching Gifts campaign helped raise over $35,000 for the AORN Foundation—and Halyard matched the first $20,000 in member contributions through our Double Your Donation sponsorship. Visit www.aorn.org/Foundation to learn more about making a gift to the Foundation.

AORN Image

NELS Halyard Advantage

The HALYARD KNOWLEDGE NETWORK* is our dynamic collection of accredited educational resources provide insight and information to clinicians on relevant and critical healthcare issues. Most courses provide Continuing Education credit for nurses, respiratory therapists, surgical technologists or central service/sterile processing department professionals. In 2016, over 27,000 attendees took advantage of these educational resources and the knowledge they provide to improve:

- Patient outcomes
- Staff competency
- Staff protection
- Hospital/facility risk reduction

The Knowledge Network curriculum includes over 80 programs, available online and in onsite presentation format, including:

Guess Who's Coming to Surgery (Patient Factors) (26:04 min)

Fire Safety in the Operating Room (27:41 min)

See all of our ESP courses

NEW INDEPENDENT STUDY1 SHOWS THAT AFTER TERMINAL STERILIZATION, 87% of rigid containers tested positive for bacterial contamination.For your free copy of this important study, CLICK HERE

CLICK HERE  to download a poster about The Sterility Maintenance Study.

For detailed information about The Sterility Maintenance Study, a KOL Roundtable Discussion, and how to test your own containers, visit our PatientSafety page.

The Study Image 135X181

Research was funded by Halyard Health, Inc. (formerly Kimberly-Clark Heath Care) and conducted by Applied Research Associates, an international research laboratory. Halyard Health did not have any direct involvement in execution of the study. The study took place in an independent laboratory in Panama City, Florida, and the study was conducted by independent researchers. 1 Harry L. Shaffer MS†, Delbert A. Harnish MS†, Michael McDonald MS, Reid A. Vernon BS, Brian K. Heimbuch MS†. Sterility maintenance study: Dynamic evaluation of sterilized rigid containers and wrapped instrument trays to prevent bacterial ingress. Am J Infect Control. 2015 Dec;43(12)1336–1341. 2 Out of 111 rigid containers tested, 14 (12.6%) had no bacterial ingress, 25 (22.5%) had ingress of 1-9 CFU, 52 (46.8%) had ingress of 10-99 CFU, and 20 (18.0%) had ingress >100 CFU. † Harry L. Shaffer MS, Delbert A. Harnish MS, and Brian K. Heimbuch MS contributed to/authored the above article at the time they had a financial consulting relationship with Halyard Health, Inc.; however, they were not compensated by Halyard Health, Inc. for their respective contributions/authorship of the article.


Every Perioperative Team has unique needs and requirements. That’s why Halyard Health brings you custom-designed services and solutions to target the areas you wish to improve. To target better compliance with AORN and AAMI guidelines, download our Simplified Guide to the Gown Guidelines poster or Contact your Halyard Rep to learn more.

OR Efficiency Broch Image 128X165


*Registered trademark or trademark of Halyard Health Inc. or its affiliates.

® AiRISTA is a registered trademark of AiRISTA LLC.

©2018 HYH. All rights reserved.



  1. Girotto, J A., et al. Optimizing your operating room: Or, why large, traditional hospitals don’t work. International Journal of Surgery. 2010; 8(5): 359-67. Available from: http://www.sciencedirect.com/science/article/pii/S1743919110000804
  2. Van Winkle, Rachelle A., et al. Operating Room Delays: Meaningful Use in Electronic Health Record, CIN: Computers, Informatics, Nursing. 2016:1.  Available from: https://nursing.duke.edu/sites/default/files/vanwinkle_article.pdf
  3. Macario, Alex, What does one minute of operating room time cost? J Clin Anes. 2010; 22: 233-36. Available from:  http://ether.stanford.edu/asc1/documents/management2.pdf
  4. Average of Medicare expenditures for surgery, hospitalization, and recovery from 2014 ranging from $16,500 to $33,000 per episode. Centers for Medicare & Medicaid Services, Comprehensive Care for Joint Replacement Model. Available from: https://innovation.cms.gov/initiatives/cjr
  5. Richter DL and Diduch DR. Cost Comparison of Outpatient Versus Inpatient Unicompartmental Knee Arthroplasty. Ortho J Sports Med. 2017 Mar;5(3), 2.
  6. Hayford T, Nelson L, Diorio A.. Projecting Hospitals’ Profit Margins Under Several Illustrative Scenarios, Working Paper Series 2016-04, Congressional Budget Office, pp. 16-17. Available from  http://www.cbo.gov/sites/default/files/114th-congress-2015-2016/workingpaper/51919-Hospital-Margins_WP.pdf