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ECONOMICS AND HEALTH SYSTEMS RESEARCH

Scheduling A Delay Between Different Surgeons’ Cases in the Same Operating Room on the Same Day Using Upper Prediction Bounds for Case Durations

Franklin Dexter, MD, PhD, Rodney D. Traub, PhD^*, and Philip Lebowitz, MD, MBA

Department of Anesthesia, University of Iowa, Iowa City, Iowa; College of Business Administration, North Dakota State University, Fargo, North Dakota; and Albert Einstein College of Medicine, Bronx, New York

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

At some surgical suites, elective cases are only scheduled if they can be completed during regularly scheduled hours. At such a surgical suite, a surgeon may be scheduled to perform one or more cases in an operating room (OR), to be followed by another surgeon who will perform one or more cases. Scheduling a delay between the two surgeons’ cases will improve the likelihood that the second surgeon’s case(s) will start on time. We show that the mathematics of calculating a scheduled delay between the different surgeons’ cases in the same OR on the same day is that of calculating an upper prediction bound for the duration of the second surgeon’s case(s). We test an analytical expression for the upper prediction bound for the last one case of the day in an OR, and a Monte Carlo simulation method for the last two cases. We show that these 90% upper prediction bounds are at least as long as the actual durations for 90% ± 0.2% of single cases and 92% ± 0.6% of pairs of cases. We conclude that our methodology can be used to calculate an appropriate, and reasonably accurate, scheduled delay between two surgeons’ cases in the same OR on the same day.

Implications: We show how to use a statistical analysis of historical case duration data to calculate an appropriate and accurate scheduled delay between two surgeons’ cases in the same operating room on the same day.

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