To the Editor:-Because of the growing costs of medical care, we have been asked to modify our practices to be more fiscally responsible. In our area, the operating room, we have undergone periodic operations improvement (OI) efforts to reduce unnecessary expenses. Nurses have been replaced with technicians, and physicians have been asked to work “more efficiently.”

We have found a simple way to significantly reduce expensive operating room time without jeopardizing patient care. Rather than moving patients on the count of three ("1–2-3" move) as had been our practice, we now count only to two ("1–2" move). Because for every case, each patient is moved to and then from the operating room table we now save 2 s per patient. We have 30 operating rooms, each with an average of 3 operations per day, so our projected savings are 180 s or 3 min per day. Approximately 600 min can be savedover the course of a year by this simple maneuver. Our operating room time costs $20/min. Thus, we can save $12,000 per annum by counting only to two. More importantly, the additional 10 h of operating room time is sufficient for another three to five cases to be performed.

With the acceptance and success of the “move-on-two” maneuver, we have initiated a pilot study of a “move-on-one” maneuver. Initial reports suggest that this can be just as safely and successfully done and will lead to a doubling of efficiency (i.e., saving time and money) over the next fiscal year.

Jay B. Brodsky, M.D.

Department of Anesthesiology; Stanford University Medical Center; Stanford, California 94305

(Accepted for publication November 7, 1997.)