I thank Harders et al.  for the comments and pointing out that some of the traditional efforts to improve operating room throughput can be considered to be “parallel processing.”1As noted by Harders et al. , improving individual functions and improving teamwork has always been essential to improving productivity independent from the actual industry or product, including the operating room.2In contrast, the editorial3and accompanying article4is focused on redesigning the larger process that goes beyond improving individual productivity and teamwork.

University of Texas Medical Branch, Galveston, Texas. aaboulei@utmb.edu

Overdyk FJ, Harvey S, Fishman R, Shippey F: Successful strategies for improving operating room efficiency at academic institutions. Anesth Analg 1998; 86:896–906
Cendan JC, Good M: Interdisciplinary work flow assessment and redesign decreases operating room turnover time and allows for additional caseload. Archives of Surgery 2006; 141:65–9
Abouleish AE: Increasing Operating Room Throughput: Just Buzzwords for This Decade? Anesthesiology 2008; 109:3–4
Smith MP, Sandberg WS, Foss J, Massoli K, Kanda M, Barsoum W, Schubert A: High-throughput operating room system for joint arthroplasties durably outperforms routine processes. Anesthesiology 2008; 109:25–35