The Association Between Timing of Elective Surgery Scheduling and Operating Theater Utilization: A Cross-Sectional...

Area of Science:

• Healthcare Operations Research
• Surgical Workflow Optimization
• Health Services Research

Background:

• Operating theater (OT) overutilization occurs when actual surgery time exceeds scheduled time, leading to potential delays and cancellations.
• Investigating the impact of elective surgery scheduling timing on OT overutilization is crucial for improving hospital efficiency.

Purpose of the Study:

• To examine the association between the timing of elective surgery scheduling and operating theater overutilization.
• To determine if scheduling surgeries within 7 days impacts actual-to-forecast (AF) ratios.

Main Methods:

• A retrospective cross-sectional study analyzed 27,423 elective surgeries using electronic health records.
• The actual-to-forecast (AF) ratio was calculated to measure scheduling precision.
• Hierarchical regression models controlled for confounding factors to isolate the effect of scheduling within 7 days.

Main Results:

• Operating theaters reserved within 7 days of surgery showed significantly higher AF ratios (1.13 vs 1.08; P < .001).
• This association was significant only for patients admitted after surgery (AF increased by 2.7%; P = .027).
• No significant difference in AF was found for outpatient, extended recovery, or inpatient groups when scheduled within 7 days.

Conclusions:

• Elective surgeries scheduled within 7 days are linked to increased OT overutilization for patients admitted post-surgery.
• A potential "squeeze-in" effect may contribute to this overutilization.
• Further multi-center studies are needed to confirm these findings.