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Dedicated operating room for emergency surgery improves access and efficiency
1The Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Ont., Canada.
Insights
A dedicated operating room (OR) for emergency surgeries reduced wait times and cancellations. This improved patient access to care and optimized surgical scheduling for both emergency and elective procedures.
Area of Science:
- Healthcare Management
- Surgical Operations
- Patient Flow Optimization
Background:
- Scheduling conflicts between emergency and elective surgeries lead to prolonged waits and cancellations.
- A dedicated operating room (OR) was implemented to address these scheduling challenges in a pediatric hospital.
Purpose of the Study:
- To evaluate the impact of a dedicated OR for emergency procedures on surgical scheduling and patient care.
- To assess improvements in operating room utilization, wait times, and case completion rates.
Main Methods:
- A comparative analysis of a 6-month pre-implementation period (2009) and a 6-month post-implementation period (2010).
- Evaluation of operating room usage, patient wait times, adherence to access targets, off-hours surgeries, cancellations, overruns, and length of stay.
Main Results:
- Wait times for priority 3 emergency patients decreased by over an hour (11h 8m to 10h 5m).
- The proportion of priority 3 patients receiving surgery within 12 hours increased from 52% to 58%.
- Elective surgery cancellations decreased significantly (1.5% to 0.7%), with a substantial reduction in overrun minutes.
Conclusions:
- A dedicated OR for emergency cases enhances the quality of care by reducing cancellations and overruns.
- Implementation of a dedicated OR improved timely access to care for emergency patients within targeted timeframes.
Background:
Scheduling emergency cases among elective surgeries often results in prolonged waits for emergency surgery and delays or cancellation of elective cases. We evaluated the benefits of a dedicated operating room (OR) for emergency procedures available to all surgical services at a large children's hospital.
Methods:
We compared a 6-month period (January 2009 to June 2009) preimplementation with a 6-month period (January 2010 to June 2010) postimplementation of a dedicated OR. We evaluated OR use, wait times, percentage of cases done within and outside of access targets, off-hours surgery, cancellations, overruns and length of stay.
Results:
Preimplementation, 1069 of the 5500 surgeries performed were emergency cases. Postimplementation, 1084 of the 5358 surgeries performed were emergency cases. Overall use of the dedicated OR was 53% (standard deviation 25%) postimplementation. Excluding outliers, the average wait time for priority 3 emergency patients decreased from 11 hours 8 minutes to 10 hours 5 minutes (p = 0.004). An increased proportion of priority 3 patients, from 52% to 58%, received surgery within 12 hours (p = 0.020). There was a 9% decrease in the proportion of priority 3 cases completed during the evening and night (p < 0.001). The elective surgical schedule benefited from the dedicated OR, with a significant decrease in cancellations (1.5% v. 0.7%, p < 0.001) and an accumulated decrease of 5211 minutes in overrun minutes in elective rooms. The average hospital stay after emergency surgery decreased from 16.0 days to 14.7 days (p = 0.12) following implementation of the dedicated OR.
Conclusion:
A dedicated OR for emergency cases improved quality of care by decreasing cancellations and overruns in elective rooms and increasing the proportion of priority 3 patients who accessed care within the targeted time.
