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Enhancement opportunities in operating room utilization; with a statistical appendix.

Elizabeth van Veen-Berkx1, Sylvia G Elkhuizen2, Sanne van Logten3

  • 1Department of Operating Rooms, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.

The Journal of Surgical Research
|December 7, 2014
PubMed
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Reducing end-of-day underused operating room (OR) time is key to improving OR utilization. Strategies include better procedure time prediction and flexible scheduling.

Area of Science:

  • Health Services Research
  • Operations Management
  • Healthcare Analytics

Background:

  • Operating room (OR) utilization is critical for healthcare efficiency.
  • Understanding factors influencing OR utilization is essential for identifying bottlenecks and improving patient flow.
  • First-case tardiness, turnover time, and underused OR time are key metrics impacting OR efficiency.

Purpose of the Study:

  • To analyze direct and indirect relationships between first-case tardiness, turnover time, underused OR time, and raw OR utilization.
  • To identify which nonoperative time indicator most negatively impacts OR utilization.
  • To explore potential "trickle down" effects of nonoperative time on daily OR efficiency.

Main Methods:

  • Utilized multiple linear regression and mediation effect analysis.
Keywords:
BenchmarkingNonoperative timeOperating roomsPerformance indicatorsUtilization

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  • Analyzed a large dataset of 190,071 OR days from eight University Medical Centers in the Netherlands.
  • Included 623,871 surgical cases in the analysis.

    • Main Results:

    • Underused OR time at the end of the day had the strongest negative impact on raw OR utilization.
    • Late start and turnover time also influenced utilization, but to a lesser extent.
    • Indirect effects of nonoperative time indicators were statistically significant but small; "trickle down" effects of late start were not supported.

    Conclusions:

    • Focusing on reducing underused OR time at the end of the day is the most effective strategy for improving OR utilization.
    • Enhancing procedure time prediction and optimizing OR scheduling (e.g., altering case sequencing, flexible staffing) can reduce nonoperative time.
    • Implementing flexible staffing and adjusting policies for patient cancellations can further enhance OR efficiency.