Description: The purpose of this project has many goals. We are attempting to reduce costly operating room time, schedule and complete additional cases during peak block time, decrease overtime costs, improve patient, physician and staff satisfaction. The clinical issues of this project was to reduce OR time for the Total Joint Orthopaedic patient population at Penn Presbyterian Medical Center. The plan is to set up an Induction Room trial to improve efficiency and throughput. The team consisted of anesthesia, nursing and SPD Department. A team charter was developed and the Induction Room was set up specifically in the preoperative holding area that had two private patient rooms. Staffing model developed with both the anesthesia team, as well as, perioperative staff. We acquired a spinal positioning chair to help with the placement of spinal/epidural catheters and set up all the necessary supplies and equipment needed to perform neuroaxial anesthesia procedures in the Induction Room. This included reworking the way we utilized staff to perform the induction of spinal anesthesia in the Induction Rooms concurrently with the operating room turnover. Nursing and support staff needed to be educated on the new process prior to the start of this project. There were several metrics that were monitored:1. In room to anesthesia start2. In room to surgeon ready3. In room to procedure start4. Procedure duration5. End of out of room6. Total room timeThe quantifiable improvements were accomplished during this trial. Two orthopaedic surgeons participated in the Induction Room trial and demonstrated a statistically significant reduction in anesthesia ready time of 12 and 11 minutes per case respectively. This reduction in anesthesia time translates to a reduction in total operating room time of 11 and 10 minutes per surgeon per case respectively. The Induction Room started out as a pilot program specific to two orthopaedic surgeons and has now expanded to include two additional surgeons. We currently have the capacity to utilize induction rooms for one surgeon per day, and this has greatly reduced operating room utilization times in those rooms. The patients also spend more time with their family in the preoperative holding area and less time waiting in the operating room. This anesthesia team model is still in effect and this has improved operating room efficiency. While operative time has nearly identical before and after, there is a statically significant reduction in intraoperative anesthesia time, which translated to reduction in overall operating room time. Establishing well-defined team roles for each operative member was crucial to the success of the program. Setting a set team in each of the Joint rooms significantly helped with the success of the project. Every staff member understood their new roles and responsibilities and this helped the team become a well-defined coherent unit working toward a common goal.