Surgical time and motion: the intermediate equivalent revisited.

Area of Science:

• Surgical Operations Research
• Healthcare Management
• Health Services Research

Background:

• Current surgical scheduling systems, like the BUPA and Collins schedules, use Intermediate Equivalent Value (IEV) to estimate procedure times.
• Accurate workload assessment and operating theatre resource management are crucial for efficient healthcare delivery.

Purpose of the Study:

• To examine the relationship between operative time, IEV, and the complexity of general surgical operations.
• To identify discrepancies between scheduled IEV and actual operative times for complex procedures.

Main Methods:

• Analysis of operative times for common general surgical operations.
• Comparison of actual theatre time with allocated IEV based on BUPA and Collins schedules.
• Inclusion of anaesthetic preparation time in the assessment.

Main Results:

• A correlation was observed between BUPA schedule values for intermediate and major procedures.
• Complex major vascular reconstruction and oesophagogastric resection significantly exceeded allocated theatre time.
• Anaesthetic preparation time added substantial time, equivalent to at least one IEV, for complex surgeries.

Conclusions:

• The current IEV weighting in surgical schedules may underestimate the time required for complex procedures.
• Re-evaluation of IEV, incorporating anaesthetic input, is necessary for accurate workload audits.
• Improved IEV weighting can facilitate better operating theatre resource management and workload transparency.