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Specific Factors Affecting Operating Room Efficiency: An Analysis of Case Time Estimates.
Devon Ryan1, Madeline Rocks1, Karen Noh2
1Division of Hand Surgery, Department of Orthopedic Surgery, NYU Langone Health, White Plains, NY.
The Journal of Hand Surgery
|November 6, 2022
Summary
Operating room (OR) efficiency is impacted by inaccurate surgical case time estimates. Nearly one-fifth of outpatient hand surgery durations are poorly estimated, often underestimated, by surgeon, procedure, and scheduled time.
Area of Science:
- Orthopedic Surgery
- Health Services Research
- Surgical Workflow Optimization
Background:
- Operating room (OR) efficiency is critical for surgeon productivity and patient satisfaction.
- Accurate estimation of surgical case duration is essential for optimizing OR efficiency and scheduling.
Purpose of the Study:
- To identify factors contributing to inaccurate case time estimates in outpatient hand surgery.
- To improve OR efficiency and scheduling through a better understanding of estimation inaccuracies.
Main Methods:
- Review of 6,620 outpatient hand surgical cases from 2018-2019.
- Definition of poorly-estimated cases as actual operative time differing from predicted time by >50%.
- Analysis of poorly-estimated cases by surgeon, procedure type, and scheduled case length.
Main Results:
- 16.7% of cases had poorly estimated durations, with 75.2% of these being underestimated.
- No significant difference in poor estimation likelihood based on case start time.
- Accurate estimates were more common for cases scheduled for 30-45 and 106-120 minutes, while 15-30 minute cases were frequently inaccurate.
Conclusions:
- Case time estimations in outpatient hand surgery are highly variable.
- Predictable outliers for inaccurate estimations include specific surgeons, procedures, and scheduled case durations.
- Addressing these factors can enhance OR efficiency and patient experience.
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