Prospective Analysis of Operating Room and Discharge Delays in a Burn Center

Area of Science:

• Medical research
• Healthcare management
• Quality improvement

Background:

• Delays in operating room (OR) and discharge (DC) processes increase hospital length of stay and associated costs.
• Quantifying the frequency and financial impact of these delays, particularly for inpatient care, remains underexplored.

Purpose of the Study:

• To quantify the incidence and causes of operating room (OR) and discharge (DC) delays in burn admissions.
• To estimate the associated costs and identify areas for improvement in patient throughput.

Main Methods:

• Prospective data collection for burn admissions from 2014 to 2016.
• Implementation of a quality improvement filter to define acceptable patient throughput parameters.
• Categorization of hospital days into: No delay, Operation, Delay to OR, or Delay to DC.

Main Results:

• Out of 1633 admissions, 20.3% experienced OR delays and 30.8% experienced DC delays.
• OR delays were primarily due to patient instability (24%) and OR space availability (41%).
• DC delays were mainly caused by placement issues (36%) and pain control/wound care (33%).
• Total hospital days attributed to OR and DC delays were 12% and 16%, respectively, with estimated costs between $1-5 million.

Conclusions:

• Significant delays in operating room and discharge processes impact burn patient care and incur substantial costs.
• Addressing OR capacity and enhancing social work support can lead to significant annual cost savings.