Optimization of Efficiency and Resource Use in Outpatient Pediatric Plastic Surgery

Pediatric plastic surgery requires significant time and resource investment from patients and hospitals. This study examines the efficiency and resource use across surgery locations at an academic pediatric plastic surgery program.

A retrospective review was performed on all patients who underwent a lesion excision performed by a single surgeon from 2023 to 2024. Case location (main campus versus Network of Care site), costs, infection rates, readmissions, and postoperative emergency department (ED) visits were collected. Operational efficiency was measured as total time spent in the OR, and patient time efficiency was measured as preoperative wait time and total time spent in the facility.

A total of 70 procedures were identified, 12 at the main campus and 58 at the Network of Care site. The average total OR costs (P=0.034) and average materials costs (P=0.040) were significantly higher at the main campus. The average procedure duration was not significantly longer at the main campus (P=0.344), but the average total time spent in OR was significantly longer (P=0.034). Patients spent more time on average waiting for their procedure (P<0.001) and in the facility overall (P<0.001). Infection rates (P=0.627) and ED visits (P=0.473) did not differ across locations. No readmissions occurred at either location.

The Network of Care site was more time-efficient and resource-efficient for the hospital and patients, while maintaining similar patient outcomes. Pediatric plastic surgery departments may preferentially shift appropriate outpatient surgical procedures to Network of Care sites to optimize resource use, enhance patient experience, and provide higher value care to patients.