Optimizing Operating Room Efficiency for Primary Hip and Knee Arthroplasty Using Performance Benchmarks.

Area of Science:

• Orthopedic Surgery
• Health Services Research
• Operating Room Management

Background:

• Increasing demand for total hip arthroplasty (THA) and total knee arthroplasty (TKA) necessitates improved operating room (OR) efficiency.
• Optimizing OR workflows is critical for meeting patient needs and managing healthcare resources effectively.

Purpose of the Study:

• To examine the impact of implementing time benchmarks on the efficiency of primary TKA and THA procedures.
• To determine if establishing benchmarks increases the number of joint replacements performed per day.

Main Methods:

• A retrospective review of 295 primary TKA and THA cases across 59 OR days was conducted.
• Established benchmarks included anesthesia preparation time (APT) <11 min, procedure time <72 min, anesthesia finish time (AFT) <21 min, and turnover <22 min for 4 joints in 8 hours.
• Patient demographics, time points, and adverse events were recorded to analyze benchmark adherence and influencing factors.

Main Results:

• High adherence rates were observed for procedure time (95.25%) and AFT (99.67%).
• Overall, 98.3% of OR days completed 4 joint replacements within 8 hours, and 52.5% completed 5 joint replacements.
• Factors such as age, body mass index, and surgical laterality influenced the ability to meet specific time benchmarks.

Conclusions:

• Establishing time benchmarks successfully enabled the completion of 5 joint replacement procedures within an 8-hour OR day.
• This efficiency was achieved without an increase in resource utilization.
• Key factors influencing OR efficiency for high-volume primary hip and knee replacements were identified.