Surgical planning for an efficient operating room is critical in the environment we face today. There is great emphasis placed on providing superior patient care with optimal outcomes while being cost efficient in running the daily operations of a robust operating room. It is imperative to provide a safe and successful process while enhancing customer satisfaction. Customers present as patients, families, and surgeons; vulnerable populations that can be lost if not kept satisfied. An effective team was built with key stakeholders that consisted of a physician champion, anesthesiologist, management leadership from each area of impact, and staff engaged in making positive changes. Selecting the appropriate individuals that are trustworthy, committed, accountable, and possessed an interest in focusing on results was essential. The team defined key expectations, created operational process changes, disseminated and educated staff and surgeons, and evaluated outcomes. It was crucial that staff feedback was elicited throughout the process to foster buy-in and produce successful outcomes. Through our collaborative and innovative process changes, our team was successful in improving on-time first case starts from 39% to 69%.