The Planning Fallacy in the Orthopedic Operating Room

Area of Science:

• Orthopedics
• Psychology
• Healthcare Management

Background:

• The planning fallacy describes the tendency to underestimate task completion times.
• This cognitive bias may affect efficiency and resource allocation in the orthopedic operating room.
• Potential negative impacts on patients, families, and surgeons necessitate investigation.

Purpose of the Study:

• To determine if the planning fallacy is present in orthopedic surgery.
• To quantify the extent of time underestimation for operative and total room times.
• To explore factors influencing estimation accuracy.

Main Methods:

• Nine orthopedic surgeons provided time estimates for 759 cases over three months.
• Operative time and total room time were recorded and compared to estimates.
• Data were analyzed to assess underestimation and identify influencing factors, including procedure location.

Main Results:

• Surgeons underestimated total room times by 17.3% (p = 0.034) but not operative times (p = 0.590).
• Estimation accuracy for operative time improved over the study period.
• In-hospital procedures showed greater underestimation than those in ambulatory centers.

Conclusions:

• The planning fallacy is evident in orthopedic surgery, particularly for total room time.
• Surgeons demonstrated improved operative time estimation with experience.
• Procedure location (hospital vs. ambulatory) influenced time estimation accuracy.