Date of Conferral

8-12-2026

Date of Award

August 2026

Degree

Doctor of Healthcare Administration (D.H.A.)

School

Health Sciences

Advisor

Kourtney Nieves

Abstract

Operating room scheduling inefficiencies in acute care hospitals contribute to delays, prolonged turnover times, cancellations, underused capacity, overtime, higher costs, and reduced timely access to surgery. This integrative review examined evidence-based, systems-oriented scheduling and workflow strategies to improve operating room utilization, reduce delays, and enhance operational efficiency. Guided by general systems theory, a structured search identified 196 database-level records; 28 articles underwent full-text review, and 20 sources were retained for thematic synthesis after critical appraisal using the Johns Hopkins Evidence-Based Practice criteria. The thematic analysis revealed four main themes: standardized workflow coordination, data-driven scheduling and decision support, integrated resource and capacity management, and robust scheduling under uncertainty. Key subthemes included first-case readiness, interdisciplinary communication, predictive analytics, multi-resource scheduling, and risk-adjusted scheduling. The findings indicate that healthcare leaders should manage operating room scheduling as an integrated hospital operating system by combining standardized workflows, data-informed decision support, coordinated resource and capacity planning, uncertainty management, multidimensional performance measurement, and multidisciplinary governance. Implementing this systems-oriented approach may reduce avoidable delays and cancellations, lessen the associated burdens on patients and families, and support safer, more reliable, and more timely access to surgical care.

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