Operating Room Performance Optimization Metrics: a Systematic Review

Abstract

Literature proposes numerous initiatives for optimization of the Operating Room (OR). Despite multiple suggested strategies for the optimization of workflow on the OR, its patients and (medical) staff, no uniform description of ‘optimization’ has been adopted. This makes it difficult to evaluate the proposed optimization strategies. In particular, the metrics used to quantify OR performance are diverse so that assessing the impact of suggested approaches is complex or even impossible. To secure a higher implementation success rate of optimisation strategies in practice we believe OR optimisation and its quantification should be further investigated. We aim to provide an inventory of the metrics and methods used to optimise the OR by the means of a structured literature study. We observe that several aspects of OR performance are unaddressed in literature, and no studies account for possible interactions between metrics of quality and efficiency. We conclude that a systems approach is needed to align metrics across different elements of OR performance, and that the wellbeing of healthcare professionals is underrepresented in current optimisation approaches.

Scaling performance frontiers across multiple perioperative services

“…Again, performance frontiers can be used in comparative analyses of multiple institutions in operating room management. Although a wide variety of metrics contributing to operating room performance may exist, a targeted approach in which relevant metrics are adjusted for study followed by evaluation of impact on the breadth of metrics for operating room performance; performance frontiers are perfectly suited for this manner of multi-objective data visualization [20]. Further, different perioperative services can understand the limitations to their own operations, and perhaps, consider redesigning them rather than aiming to meet the minimal standard of an OR management metric.…”

Team Approach: Improving Orthopaedic Operating Room Efficiency

“…In a review of 39 studies, Fong et al 8 demonstrated that most studies studied time or money as their metric for efficiency. Schouten et al 27 performed a systematic review and identified that currently no studies account for interactions between metrics of quality and efficiency. Further studies are needed to identify the optimal calculation of metrics that accurately reflect OR efficiency and quality to ensure value to both the patients and institutions.…”

Documenting Perioperative Care in the Electronic Health Record

“…Perioperative and organizational leaders focus on maximizing OR efficiency, a process that likely equates time (eg, delays, on-time starts, between-procedure turnover) with cost. 20 This focus results in a culture that rewards personnel for efficiency and prioritization of practical, patient-related tasks. 21 Nurses do not always prioritize documentation in the same manner as other patient safety concerns (eg, time out, retained surgical item) and key performance metrics.…”

“…Perioperative and organizational leaders focus on maximizing OR efficiency, a process that likely equates time (eg, delays, on‐time starts, between‐procedure turnover) with cost 20 . This focus results in a culture that rewards personnel for efficiency and prioritization of practical, patient‐related tasks 21 .…”