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Case-Mix Moderation of the Relationship Between OR Performance Metrics and Utilization
AORN Journal
|November 28, 2022
Summary
Optimizing operating room (OR) utilization involves managing idle time and late starts. The mix of inpatients versus outpatients also impacts OR efficiency, particularly for cancellations and turnover time.
Area of Science:
- Healthcare Management
- Surgical Operations
- Health Services Research
Background:
- Operating room (OR) utilization is a critical metric in healthcare, directly impacting efficiency and profitability.
- Understanding factors influencing OR utilization, such as patient case mix, is essential for effective perioperative management.
- Previous research has explored various operational factors, but the specific impact of inpatient-to-outpatient ratios on OR utilization metrics requires further investigation.
Purpose of the Study:
- To investigate how the ratio of inpatients to outpatients affects the relationships between operating room (OR) utilization and key performance indicators.
- To analyze the influence of case mix on OR utilization metrics including late starts, turnover time, delays, cancellations, and idle time.
Main Methods:
- A retrospective analysis of 55 months of surgical repository data from an academic medical center.
- Utilized simple and multiple linear regression models to assess the strength and direction of relationships between variables.
- Compared analytical models with varying proportions of inpatients and outpatients to determine the effects of case mix on OR utilization.
Main Results:
- Idle time demonstrated the most significant impact on OR utilization, followed by late starts and turnover time.
- The case mix of patients (inpatients vs. outpatients) was found to moderate the relationship between OR utilization and cancellations, as well as turnover time.
- Specific patient case mix ratios influenced the predictability of OR utilization based on operational metrics.
Conclusions:
- Perioperative leaders can enhance operating room (OR) utilization by focusing on minimizing idle time and late starts.
- Strategic scheduling of an appropriate mix of inpatients and outpatients is crucial for optimizing OR turnover time and reducing cancellations.
- Addressing both operational inefficiencies and patient case mix is vital for maximizing OR efficiency.
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