Opportunities for increased efficiencies can be evaluated by assessing current processes and examining the components of each step to identify adjustments for improvements within a hospital's perioperative department. General systems theory identifies dynamic relationships exist within an open system and components of the perioperative department can be categorized into input, throughput and output. This framework was used to evaluate nursing interventions concerning throughput in an ambulatory and acute care setting. A retrospective chart review utilizing post anesthesia care unit interval times was completed to determine whether preemptive oral narcotic administration impacts times and pain levels of 125 outpatient laparoscopic cholecystectomy patients in these settings. Summary statistics and regression analyses were utilized to evaluate preemptive pain management interventions on perioperative throughput. The researcher found the ambulatory surgery center to be more effective in postoperative throughput and pain control than the acute care setting. The data supported decreased PACU time with the administration of 10mg of Oxycotin 60 minutes before a laparascopic cholecystectomy. As nurses, we should advocate administration of preemptive analgesia in the perioperative setting.