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ECONOMICS AND HEALTH SYSTEMS RESEARCH

Decrease in Case Duration Required to Complete an Additional Case During Regularly Scheduled Hours in an Operating Room Suite: A Computer Simulation Study

Franklin Dexter, MD, PhD^*, and Alex Macario, MD, MBA

*Department of Anesthesia, University of Iowa, Iowa City, Iowa; and Department of Anesthesia, Stanford University, Palo Alto, California

Address correspondence and reprint requests to Franklin Dexter, Department of Anesthesia, University of Iowa, Iowa City, IA 52242. Address e-mail to franklin-dexter{at}uiowa.edu

We used Monte-Carlo computer simulation to determine whether surgical or anesthetic interventions to achieve small decreases in case duration may create enough new open operating room (OR) time to permit an additional case to be scheduled for completion in an OR suite during regular working hours. We used rules for scheduling of cases assuming that OR personnel are compensated so that the OR suite can profit financially from decreasing case duration to complete an additional case during regularly scheduled hours. The decreases in each case's duration required to create enough new open OR time to reliably (95%) schedule another case were 30–39 min, 79–110 min, and 105–206 min for OR suites with 1–15 ORs and mean case durations of 1, 2, or 3 h, respectively.

Implications: Computer simulation shows decreasing case duration is unlikely to create sufficient operating room time to reliably permit an additional case to be scheduled for completion during working hours. Additional cases may best be added to the operating room suite schedule by optimizing case scheduling, not by decreasing the duration of all cases in the suite.

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