Creating highly efficient operating room protocols for total joint arthroplasty (TJA) is a challenging and multifactorial process. This evidence-based technique video will introduce block bay spinal anesthesia as a possible method to improve operating room efficiency. The video reviews literature on the creation of high-efficiency operating room protocols for TJA. Increasing operating room efficiency via parallel processing is introduced and discussed. The video then reviews the abstract titled "Spinal Anesthesia in a Designated Block Bay for Total Joint Arthroplasty: Improving Operating Room Efficiency" by Kagan et al. This abstract evaluates if spinal anesthesia administered in a designated block bay adjacent to the operating room decreases turnover time, improves first case start time, and decreases conversion to general anesthesia. A case example, which includes preoperative and postoperative imaging studies, illustrates the workflow and processes developed at our institution to safely and efficiency administer spinal anesthesia in a designated block bay for TJA. Clinical pearls and risks are discussed, and the limitations of the abstract are reviewed. We hope this process helps other institutions create efficiencies in TJA.