Fast-track ENT days boost surgical volume, cut backlog at UCSF Benioff Children’s

Editor's Note

Designating underused neurosurgery blocks for straightforward ENT procedures increased surgical volume and reduced wait times at UCSF Benioff Children’s Hospital San Francisco, according to a July 3 report from the Children’s Hospital Association’s 2025 Transforming Quality Conference.

The initiative began in early 2024, when ENT leaders and surgical services sought to address a growing ENT backlog alongside underused operating room capacity. They repurposed one neurosurgery block per month for “fast-track days” focused exclusively on simple ear tubes, adenoidectomies, and myringotomies for healthy patients. According to the organization, this increased total ENT throughput by approximately 15 cases per month. Over the following year, the ENT backlog decreased by 16%, and overall ENT case volume grew by 13%, including more complex cases during regular OR hours.

As detailed in the report, successful execution required coordination across multiple teams, including ENT clinic staff, anesthesia, nursing leaders, sterile processing, equipment techs, environmental services, and pharmacy. Staffing each fast-track OR with two nurses—one managing the current case and the other preparing the next—facilitated continuous workflow, occasional medication recovery, and patient check-in without disrupting the surgical rhythm. Other contributors included administering medication intranasally or intramuscularly to avoid placing peripheral IVs, using endotracheal for adenoidectomies, and using laryngeal mask airways for ear tubes and myringotomies.

Other details in the full report include early challenges and the role of communication and early action (such as locking in block allocations weeks in advance).