| ||||||||||||||
|
|
|||||||||||||
Department of Anesthesia, University of Iowa, Iowa City, Iowa
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
Determining the appropriate amount of block time to allocate to surgeons and selecting the days on which to schedule elective cases can maximize operating room (OR) use. We used computer simulation to model OR scheduling. Inputs in the computer model included different methods to determine when a patient will have surgery (on-line bin-packing algorithms), case durations, lengths of time patients wait for surgery (2 wk is the median longest length of time that the outpatients [n = 367] surveyed considered acceptable), hours of block time each day, and number of blocks each week. For block time to be allocated to maximize OR utilization, two parameters must be specified: the method used to decide on what day a patient will have surgery and the average length of time patients wait to have surgery. OR utilization depends greatly on, and increases as, the average length of time patients wait for surgery increases.
Implications: Operating room utilization can be maximized by allocating block time for the elective cases based on expected total hours of elective cases, scheduling patients into the first available date provided open block time is available within 4 wk, and otherwise scheduling patients in "overflow" time outside of the block time.
This article has been cited by other articles:
![]() |
J. J. Pandit and F. Dexter Lack of Sensitivity of Staffing for 8-Hour Sessions to Standard Deviation in Daily Actual Hours of Operating Room Time Used for Surgeons with Long Queues Anesth. Analg., June 1, 2009; 108(6): 1910 - 1915. [Abstract] [Full Text] [PDF] |
||||
![]() |
F. Dexter, L. Birchansky, J. M. Bernstein, and R. E. Wachtel Case Scheduling Preferences of One Surgeon's Cataract Surgery Patients Anesth. Analg., February 1, 2009; 108(2): 579 - 582. [Abstract] [Full Text] [PDF] |
||||
![]() |
F. Dexter and R. H. Epstein Calculating Institutional Support That Benefits Both the Anesthesia Group and Hospital Anesth. Analg., February 1, 2008; 106(2): 544 - 553. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. E. Wachtel and F. Dexter Tactical Increases in Operating Room Block Time for Capacity Planning Should Not Be Based on Utilization Anesth. Analg., January 1, 2008; 106(1): 215 - 226. [Abstract] [Full Text] [PDF] |
||||
![]() |
F. Dexter, Y. Xiao, A. J. Dow, M. M. Strader, D. Ho, and R. E. Wachtel Coordination of Appointments for Anesthesia Care Outside of Operating Rooms Using an Enterprise-Wide Scheduling System Anesth. Analg., December 1, 2007; 105(6): 1701 - 1710. [Abstract] [Full Text] [PDF] |
||||
![]() |
F. Dexter and R. E. Wachtel Patient Waiting Time Matters When Filling a Pod of Operating Rooms Arch Surg, November 1, 2007; 142(11): 1114 - 1114. [Full Text] [PDF] |
||||
![]() |
M. Van Houdenhoven, J. M. van Oostrum, E. W. Hans, G. Wullink, and G. Kazemier Improving Operating Room Efficiency by Applying Bin-Packing and Portfolio Techniques to Surgical Case Scheduling Anesth. Analg., September 1, 2007; 105(3): 707 - 714. [Abstract] [Full Text] [PDF] |
||||
![]() |
F. Dexter Operating Room Efficiency in the National Health Service Anesth. Analg., July 1, 2007; 105(1): 291 - 292. [Full Text] [PDF] |
||||
![]() |
E. R. Mariano, L. F. Chu, C. Ramamoorthy, and A. Macario Scheduling Elective Pediatric Procedures That Require Anesthesia: The Perspective of Parents Anesth. Analg., December 1, 2006; 103(6): 1426 - 1431. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. McIntosh, F. Dexter, and R. H. Epstein The Impact of Service-Specific Staffing, Case Scheduling, Turnovers, and First-Case Starts on Anesthesia Group and Operating Room Productivity: A Tutorial Using Data from an Australian Hospital Anesth. Analg., December 1, 2006; 103(6): 1499 - 1516. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. M. Sator-Katzenschlager, M. M. Wolfler, S. A. Kozek-Langenecker, K. Sator, P.-G. Sator, B. Li, G. Heinze, and M. O. Sator Auricular electro-acupuncture as an additional perioperative analgesic method during oocyte aspiration in IVF treatment Hum. Reprod., August 1, 2006; 21(8): 2114 - 2120. [Abstract] [Full Text] [PDF] |
||||
![]() |
F. Dexter, J. C. Yue, and A. J. Dow Predicting anesthesia times for diagnostic and interventional radiological procedures. Anesth. Analg., May 1, 2006; 102(5): 1491 - 1500. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. E. Stahl, D. Rattner, R. Wiklund, J. Lester, M. Beinfeld, and G. S. Gazelle Reorganizing the System of Care Surrounding Laparoscopic Surgery: A Cost-Effectiveness Analysis Using Discrete-Event Simulation Med Decis Making, October 1, 2004; 24(5): 461 - 471. [Abstract] [PDF] |
||||
![]() |
D. C. Tyler, C. A. Pasquariello, and C.-H. Chen Determining Optimum Operating Room Utilization Anesth. Analg., April 1, 2003; 96(4): 1114 - 1121. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. E. Abouleish, S. L. Hensley, M. H. Zornow, and D. S. Prough Inclusion of Turnover Time Does Not Influence Identification of Surgical Services that Over- and Underutilize Allocated Block Time Anesth. Analg., March 1, 2003; 96(3): 813 - 818. [Abstract] [Full Text] [PDF] |
||||
![]() |
F. Dexter, D. A. Lubarsky, and J. T. Blake Sampling Error Can Significantly Affect Measured Hospital Financial Performance of Surgeons and Resulting Operating Room Time Allocations Anesth. Analg., July 1, 2002; 95(1): 184 - 188. [Abstract] [Full Text] [PDF] |
||||
![]() |
F. Dexter and A. Macario Changing Allocations of Operating Room Time From a System Based on Historical Utilization to One Where the Aim is to Schedule as Many Surgical Cases as Possible Anesth. Analg., May 1, 2002; 94(5): 1272 - 1279. [Abstract] [Full Text] [PDF] |
||||
![]() |
F. Dexter and R. D. Traub How to Schedule Elective Surgical Cases into Specific Operating Rooms to Maximize the Efficiency of Use of Operating Room Time Anesth. Analg., April 1, 2002; 94(4): 933 - 942. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. H. Epstein and F. Dexter Statistical Power Analysis to Estimate How Many Months of Data Are Required to Identify Operating Room Staffing Solutions to Reduce Labor Costs and Increase Productivity Anesth. Analg., March 1, 2002; 94(3): 640 - 643. [Abstract] [Full Text] [PDF] |
||||
![]() |
F. Dexter, J. T. Blake, D. H. Penning, and D. A. Lubarsky Calculating a Potential Increase in Hospital Margin for Elective Surgery by Changing Operating Room Time Allocations or Increasing Nursing Staffing to Permit Completion of More Cases: A Case Study Anesth. Analg., January 1, 2002; 94(1): 138 - 142. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Macario, F. Dexter, and R. D. Traub Hospital Profitability per Hour of Operating Room Time Can Vary Among Surgeons Anesth. Analg., September 1, 2001; 93(3): 669 - 675. [Abstract] [Full Text] [PDF] |
||||
![]() |
F. Dexter, R. H. Epstein, and H. M. Marsh A Statistical Analysis of Weekday Operating Room Anesthesia Group Staffing Costs at Nine Independently Managed Surgical Suites Anesth. Analg., June 1, 2001; 92(6): 1493 - 1498. [Abstract] [Full Text] [PDF] |
||||
![]() |
F. Dexter, A. Macario, and D. A. Lubarsky The Impact on Revenue of Increasing Patient Volume at Surgical Suites with Relatively High Operating Room Utilization Anesth. Analg., May 1, 2001; 92(5): 1215 - 1221. [Abstract] [Full Text] [PDF] |
||||
![]() |
F. Dexter, R. D. Traub, and P. Lebowitz Scheduling A Delay Between Different Surgeons' Cases in the Same Operating Room on the Same Day Using Upper Prediction Bounds for Case Durations Anesth. Analg., April 1, 2001; 92(4): 943 - 946. [Abstract] [Full Text] [PDF] |
||||
![]() |
F. Dexter, T. J. Gan, M. Naguib, and D. A. Lubarsky Cost Identification Analysis for Succinylcholine Anesth. Analg., March 1, 2001; 92(3): 693 - 699. [Abstract] [Full Text] [PDF] |
||||
![]() |
F. Dexter, A. Macario, and R. D. Traub Enterprise-Wide Patient Scheduling Information Systems to Coordinate Surgical Clinic and Operating Room Scheduling Can Impair Operating Room Efficiency Anesth. Analg., September 1, 2000; 91(3): 617 - 626. [Full Text] [PDF] |
||||
![]() |
F. Dexter and R. D. Traub Sequencing Cases in the Operating Room: Predicting Whether One Surgical Case will Last Longer than Another Anesth. Analg., April 1, 2000; 90(4): 975 - 979. [Abstract] [Full Text] [PDF] |
||||
![]() |
F. Dexter, A. Macario, and L. O’Neill Scheduling Surgical Cases into Overflow Block Time-- Computer Simulation of the Effects of Scheduling Strategies on Operating Room Labor Costs Anesth. Analg., April 1, 2000; 90(4): 980 - 988. [Abstract] [Full Text] [PDF] |
||||
![]() |
W. J. Mazzei Maximizing Operating Room Utilization: A Landmark Study Anesth. Analg., July 1, 1999; 89(1): 1 - 1. [Full Text] [PDF] |
||||
|