Short turnover times and efficient use of time and personnel are hallmarks of an efficiently run OR. When delays occur, time can be lost and the workday prolonged considerably. This article describes changes made in neurosurgical services at Utah Valley Regional Medical Center, Provo. These changes involved redesign of the neurosurgical suite and simplification of processes, which led to a 33% to 55% decrease in turnover times and an increase in team efficiency and the number of nurses proficient in the specialty.