Estimating the duration of common elective operations: implications for operating list management

Area of Science:

• Surgical Operations Management
• Healthcare Efficiency
• Patient Safety

Background:

• Day-of-surgery cancellations are frequently caused by operating lists running over time.
• Optimistic time estimations by surgeons may contribute to the overbooking of operating lists.

Purpose of the Study:

• To investigate if surgeons' optimistic time estimates lead to overbooked operating lists.
• To assess the accuracy of time estimates for surgical procedures and their impact on scheduling.

Main Methods:

• A questionnaire assessed operation time estimates from surgeons, anaesthetists, and nursing staff for 31 procedures.
• Estimates were compared to actual theatre computer records.
• Surgeons' average estimates were prospectively applied to 50 surgical lists to evaluate booking accuracy.

Main Results:

• No significant difference was found between the time estimates of surgeons, anaesthetists, and nursing staff, nor between these estimates and actual theatre records (p = 0.722).
• Surgeons' estimates accurately predicted list duration (r2= 0.61; p < 0.001).
• However, estimates were poor for booking, with 50% of lists predictably overbooked, 50% over-running scheduled time, and 34% resulting in cancellations.

Conclusions:

• While surgeon time estimates predict operating list duration well, they are inadequate for effective scheduling.
• Implementing accurate operating time estimates in list planning can significantly reduce predictable over-runs and cancellations, improving surgical workflow and patient care.