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Legacy Good Samaritan leads U.S. <BR>in new improvements

March 2013

Legacy Good Samaritan Medical Center will be the first hospital in North America to adopt "The Productive Operating Theatre” (TPOT), a new internationally used health care improvement program.

The program uses lean processes commonly seen in the automotive industry and combines them with a shared governance model to streamline process and procedures. TPOT will be implemented in Legacy Good Samaritan’s Operating Room, Post-Anesthesia Care Unit, Pre-Admission Services and Short Stay Unit.

Legacy Good Samaritan was chosen to pioneer TPOT because it has already demonstrated that it is ahead of the curve when it comes to innovative improvement programs.

Positive impacts

According to the UK NHS Institute for Innovation and Improvement, The Productive Operating Theatre positively impacts:

  • Team performance and staff well-being
  • Safety and reliability of care
  • Value and efficiency to enhance the patient’s experience


"As the health care landscape continues to evolve, it is more important than ever to be responsible stewards of our resources and time,” said Tony Melaragno, M.D., chief administrative officer at the hospital. “By reducing unnecessary waste and streamlining staff interaction, TPOT will enhance patient care at Legacy Good Samaritan.”

Improvements physicians and surgeons can expect to see

  • Improved patient experience and outcomes by
    -Reducing wait times in the SSU
    -Reducing pain
    -Offering consistent care coordination
  • Improved teamwork and communication between surgeons, anesthesia and staff leading to
    -Improved job satisfaction, teamwork and patient safety
    -Reduced errors, improved reliability
  • Improvement in efficiency with patient throughput, which will
    -Improve start times
    -Reduce turnover times
    -Increase time with the patient
  • Savings on supplies and equipment reductions

Progress to date

  • Process improvement team champions have been elected. We have four surgeon and two anesthesia champions to support the program.
  • Dot voting is occurring for all decisions and changes involving surgeons, anesthesia providers and staff.
  • So far, 33 surgeons have voted on the top three opportunities for improvement in the OR and the Surgical Services vision statement.
  • The top opportunities for improvement are:
    -Patient flow/efficiency/throughput
    -Turnovers (help, expectations, education)
    -Patient fully prepared pre-admit


The next step is to identify which metrics to collect in order to support the process modules and improvement initiatives for process improvement progress. Updates will be presented at the Legacy Good Samaritan Quality and Surgery Executive committees.


Established in September 2009, TPOT been implemented in Australia, New Zealand, Qatar and Denmark and is rolling out to all National Health Service (NHS) hospitals in England.

Legacy Good Samaritan received a grant from CareOregon to pilot the program. After completion of the pilot, Legacy will evaluate the benefits of the program for possible implementation at other Legacy hospitals.

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