Contributors to Operating Room Underutilization and Implications for Hospital Administrators

Area of Science:

• Healthcare Management
• Hospital Operations Research
• Surgical Workflow Optimization

Background:

• Operating room (OR) utilization is a critical metric for hospital revenue and efficiency.
• OR managers may hold biased perceptions regarding the primary causes of OR underutilization.
• Understanding the true drivers of OR inefficiency is essential for targeted improvements.

Purpose of the Study:

• To identify and quantify the factors contributing to operating room underutilization at an academic tertiary care center.
• To compare the impact of various OR underutilization contributors on overall efficiency.
• To challenge potential biases in OR management regarding the predominant causes of inefficiency.

Main Methods:

• Retrospective data collection over a 12-month period.
• Quantification of OR underutilization in terms of lost hours.
• Statistical comparison of contributing factors (patient in room, turnover time, scheduling gaps, OR holds, closed rooms) using unpaired t tests.

Main Results:

• Mid/end-of-day scheduling gaps were the largest contributor to OR underutilization (9.7% of hours, P < .0001).
• Closed operating rooms also significantly contributed to underutilization (4.6% of hours, P < .0001).
• Turnover time (2.0%) and patient in room (0.8%) had the least impact on OR underutilization (P < .0001).

Conclusions:

• OR underutilization is driven by complex, multifactorial issues.
• Perceptions of OR inefficiency among staff may differ from actual data.
• System-level changes informed by accurate data are necessary to improve OR efficiency by reducing underutilization.