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Turnover Time in Neuroangiography Suites: Comparison Between Cases Performed at an Ambulatory Neurosurgery Center
Pui Man Rosalind Lai1,2,3,4, Vinay Jaikumar1,3, Erika L Leasher1
1Department of Neurosurgery (P.M.R.L., V.J., E.L.L., V.S., G.M.C., E.I.L.), University at Buffalo, NY.
Background:
Efficient turnover time (TOT) and adherence to first-start time (FST) in operating and angiography suites are critical for optimizing workflow, reducing costs, and maximizing patient satisfaction. Hospitals face challenges in maintaining these metrics due to operational constraints and unexpected emergent cases. Our goal was to compare TOT, FST, and total admission time for elective cases performed in angiography suites at an ambulatory neurosurgery center (ANSC) versus a tertiary hospital (TH).
Methods:
We conducted a retrospective analysis of data for patients who underwent elective diagnostic or interventional neuroendovascular procedures at the TH or ANSC from January 2024 through October 2024. TOT was defined as the time between the end of one case and the start of the next. FST was defined as the time the first patient of the day entered the suite. In addition, digital subtraction angiography cases at the ANSC were age- and indication-matched with same-day discharge digital subtraction angiography cases from the TH to compare total admission, preprocedural wait, procedural, and postprocedural times (minutes).
Results:
A total of 1174 procedures were performed at the TH and 155 at the ANSC. Mean TOT was longer at the TH (30.6 ± 25 minutes) than the ANSC (12 ± 2.8 minutes; P<0.0001). Mean FST was later at the TH (7:29 am±29 minutes) than the ANSC (7:22 am±21 minutes; P=0.02). In the matched digital subtraction angiography case-cohort analysis, mean total admission time was significantly longer at the TH (TH: 566 ± 148.9 versus ANSC: 279 ± 66.2 minutes; P<0.01). This difference was consistent across preprocedural wait (TH: 213.1 ± 120.3 versus ANSC: 103.8 ± 59.6 minutes; P<0.001), procedural (TH:59.8 ± 20.7 versus ANSC36.7 ± 10.6; P<0.001), and postprocedural (TH: 293.3 ± 107.6 versus ANSC: 138.4 ± 35.9; P<0.001) times.
Conclusions:
Data for ANSC procedures demonstrated significantly improved operational efficiency compared with TH procedures, with shorter TOT, earlier FST, and reduced total admission durations for elective digital subtraction angiography cases. These findings support the growing role of ANSCs in optimizing resource utilization and efficiency while maintaining high-quality patient care.
