Dedicated operating room for emergency surgery generates more utilization, less overtime, and less cancellations

Area of Science:

• Healthcare Management
• Surgical Operations
• Hospital Administration

Background:

• Two primary strategies exist for allocating operating room (OR) capacity for emergency surgeries: dedicated emergency ORs versus virtual emergency teams created by distributing capacity among elective ORs.
• Prior research offers conflicting evidence regarding the optimal approach for OR utilization and emergency case management.

Purpose of the Study:

• To compare the real-world performance of dedicated emergency operating rooms versus a virtual emergency team model.
• To evaluate the impact of each approach on operating room utilization, overtime, and surgical case cancellations.

Main Methods:

• A quasi-experimental, controlled time-series design was employed, analyzing empirical data from three university medical centers.
• Performance metrics were assessed across four distinct time periods using analysis of variance with contrasts, examining 467,522 surgical cases.

Main Results:

• Closing a dedicated emergency OR led to a slight increase in utilization but also a rise in overtime, contrary to simulation findings.
• Control centers maintaining dedicated emergency ORs demonstrated greater utilization increases and decreased overtime.
• Dedicated emergency ORs were associated with a lower rate of case cancellations due to emergency surgical demands.

Conclusions:

• In practical hospital settings, a dedicated emergency operating room is the preferred model.
• This approach optimizes operating room utilization, effectively manages surgeon overtime, and reduces the frequency of surgical case cancellations.