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ECONOMICS, EDUCATION, AND HEALTH SYSTEMS RESEARCH

How to Release Allocated Operating Room Time to Increase Efficiency: Predicting Which Surgical Service Will Have the Most Underutilized Operating Room Time

Franklin Dexter, MD, PhD^*, Rodney D. Traub, PhD, and Alex Macario, MD, MBA

*Division of Management Consulting, Department of Anesthesia, University of Iowa, Iowa City, Iowa; College of Business Administration, North Dakota State University, Fargo, North Dakota; and Department of Anesthesia, Stanford University, Stanford, California

Address correspondence and reprint requests 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 many facilities, surgeons and patients choose the day of surgery, cases are not turned away, and staffing is adjusted to maximize operating room (OR) efficiency. If a surgical service has already filled its allocated OR time, but has an additional case to schedule, then OR efficiency is increased by scheduling the new case into the OR time of a different service with much underutilized OR time. The latter service is said to be "releasing" its allocated OR time. In this study, we analyzed 3 years of scheduling data from a medium-sized and a large surgical suite. Theoretically, the service that should have its OR time released is the service expected to have the most underutilized OR time on the day of surgery (i.e., any future cases that may be scheduled into that service’s time also need to be factored in). However, we show that OR efficiency is only slightly less when the service whose time is released is the service that has the most allocated but unscheduled (i.e., unfilled) OR time at the moment the new case is scheduled. In contrast, compromising by releasing the OR time of a service other than the one with the most allocated but unscheduled OR time markedly reduces OR efficiency. OR managers can use these results when releasing allocated OR time.

IMPLICATIONS: When a service has filled its allocated operating room (OR) time and has a new case to schedule, OR efficiency is maximized by scheduling the case into the OR time of another service. The service whose OR time is released can be the service with the largest difference between allocated and scheduled OR time at the time when the new case is scheduled.

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