The smooth course of the preoperative affects directly the operating room efficiency, especially the first patient, for which if there occurs any mistake it may delay, even upset the whole operating room procedure. After studying the whole operating room procedure of a Medical Center at southern part of Taiwan, we found that the smooth course of the preoperative procedure requires effective time control、decent cooperation in participants and sections、successful system and fine personnel administration. The ameliorative project being performed through spring 1996 to spring 1997, which include system procedure simplification、 regulation revision and reinforced personnel administration. The result reveals that the abnormality in first patient preoperative procedure descended to 22.2% 1997 from 47.6% 1996. In addition, the average shortened 45 minutes waiting time of each case, thus we know that we took the right steps in improve the whole operating room efficiency.