Criteria for assessing operating room utilization in a free‐standing children’s hospital

Ferrari, Lynne R.; Micheli, Anne; Whiteley, Chris G.; Chazaro, Raoul; Zurakowski, David

doi:10.1111/j.1460-9592.2011.03690.x

Cited by 15 publications

(14 citation statements)

References 28 publications

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“…In turn, with this type of functioning, in other words, the decision-making process, is very much left to be guided by unspecified, intuitive criteria, that may vary between doctors [ 13 ]. In this context, the use of the corresponding operation room time, is usually under-optimal, since often, not all usable time is used [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Optimization and planning of operating theatre activities: an original definition of pathways and process modeling

Barbagallo

Corradi²,

Goyet

et al. 2015

BMC Med Inform Decis Mak

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BackgroundThe Operating Room (OR) is a key resource of all major hospitals, but it also accounts for up 40 % of resource costs. Improving cost effectiveness, while maintaining a quality of care, is a universal objective. These goals imply an optimization of planning and a scheduling of the activities involved. This is highly challenging due to the inherent variable and unpredictable nature of surgery.MethodsA Business Process Modeling Notation (BPMN 2.0) was used for the representation of the “OR Process” (being defined as the sequence of all of the elementary steps between “patient ready for surgery” to “patient operated upon”) as a general pathway (“path”). The path was then both further standardized as much as possible and, at the same time, keeping all of the key-elements that would allow one to address or define the other steps of planning, and the inherent and wide variability in terms of patient specificity. The path was used to schedule OR activity, room-by-room, and day-by-day, feeding the process from a “waiting list database” and using a mathematical optimization model with the objective of ending up in an optimized planning.ResultsThe OR process was defined with special attention paid to flows, timing and resource involvement. Standardization involved a dynamics operation and defined an expected operating time for each operation. The optimization model has been implemented and tested on real clinical data. The comparison of the results reported with the real data, shows that by using the optimization model, allows for the scheduling of about 30 % more patients than in actual practice, as well as to better exploit the OR efficiency, increasing the average operating room utilization rate up to 20 %.ConclusionsThe optimization of OR activity planning is essential in order to manage the hospital’s waiting list. Optimal planning is facilitated by defining the operation as a standard pathway where all variables are taken into account. By allowing a precise scheduling, it feeds the process of planning and, further up-stream, the management of a waiting list in an interactive and bi-directional dynamic process.

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Section: Introductionmentioning

confidence: 99%

Optimization and planning of operating theatre activities: an original definition of pathways and process modeling

Barbagallo

Corradi²,

Goyet

et al. 2015

BMC Med Inform Decis Mak

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show abstract

“…Regardless, it is essential that every endoscopy location has a standardized anesthesia setup, including an anesthesia machine, American Society of Anesthesiologists physical status (ASA) standard monitoring, an anesthesia cart, and a suction apparatus [3][4][5][6]. Good coordination and organization of the procedures in the main operating room and outside locations is very important for the safety of the patients and the efficiency of all involved in services [7].…”

Section: Introductionmentioning

confidence: 99%

“…To maintain effective throughput in managing the high volume of gastrointestinal procedures, the teams should be focused and efficient [1 7]. High-quality care and safety for the patient in outside locations requires expertise and experience of the anesthesiologist and nonanesthesiologist services [8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Adult and pediatric anesthesia/sedation for gastrointestinal procedures outside of the operating room

Er¹

2015

Current Opinion in Anaesthesiology

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Both anesthesiologists and nonanesthesiologists have to achieve a consensus and develop quality-improvement strategies to provide safe and efficient anesthesia and sedation for gastrointestinal procedures outside of the operating room for pediatric and adult patients. Techniques using TIVA, TCI, intravenous or topical application of lidocaine, and the video laryngoscope may improve and facilitate gastrointestinal procedures for the patients, the anesthesiologists, and the gastroenterologists.

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“…Many researchers have acknowledged the effects of specific performance metrics on OR utilization, including late starts, 12‐17 turnover time, 12,15,18 delays, 15,19‐23 cancellations, 9,12,13,16,19,21,24‐28 and idle time at the end of the workday 23,28 . However, with the exception of a single study completed in the Netherlands, 28 the interrelationship of all performance metrics and their effects on OR utilization remain undescribed.…”

mentioning

confidence: 99%

Case‐Mix Moderation of the Relationship Between OR Performance Metrics and Utilization

Elliott‐Dawe¹,

Chen²,

Zadinsky³

2022

AORN Journal

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We investigated the impact of the case-mix ratio of inpatients to outpatients on the relationships between OR utilization and late starts, turnover time, delays, cancellations, and idle time at an academic medical center in the southeastern United States. After extracting 55 months of data from the surgical repository, we used simple and multiple linear regression models to analyze the data and determine the strength and direction of the relationships among the variables. We compared models comprising proportionally more inpatients to models comprising proportionally more outpatients for each metric to ascertain the effects of case mix on OR utilization. Idle time had the greatest effect on OR utilization, followed by late starts and turnover time. Case mix moderated the relationship between OR utilization and the metrics of cancellations and turnover time. Perioperative leaders may enhance OR utilization by monitoring and addressing idle time and late starts and scheduling an appropriate mix of inpatients and outpatients.

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Criteria for assessing operating room utilization in a free‐standing children’s hospital

Cited by 15 publications

References 28 publications

Optimization and planning of operating theatre activities: an original definition of pathways and process modeling

Optimization and planning of operating theatre activities: an original definition of pathways and process modeling

Adult and pediatric anesthesia/sedation for gastrointestinal procedures outside of the operating room

Case‐Mix Moderation of the Relationship Between OR Performance Metrics and Utilization

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