
Improving operating room start times in a community teaching hospital
Author(s) -
Alex Darwish,
Pratik Mehta,
Ahmed Mahmoud,
Amr El-Sergany,
David Culberson
Publication year - 2016
Publication title -
journal of hospital administration
Language(s) - English
Resource type - Journals
eISSN - 1927-7008
pISSN - 1927-6990
DOI - 10.5430/jha.v5n3p33
Subject(s) - revenue , tardiness , medicine , operations management , documentation , business , finance , management , computer science , economics , schedule , job shop scheduling , programming language
The operating room (OR) is an expensive entity to manage. Efficiency in hospital resource utilization is critical for hospital financial solvency. One measure of efficiency in the OR is percentage of on-time starts for cases at the beginning of each day. This study looks at a community teaching hospital where measures were taken to identify and address causes of tardiness in the OR.Methods: An interdisciplinary team of doctors, nurses, and other hospital staff came together to implement a three-phase agenda. In Phase I, staff identified causes of tardiness. In Phase II, potential solutions to address each specific task were drawn up. Phase III involved maintenance of efficiency measures created in Phase II and documentation of progress for future analysis.Results and Discussion: Over twelve months, the percentage of cases that started on time steadily increased from 14% to 68%. Additionally, of the cases that were late, the average number of minutes late decreased significantly. Of the identified causes of tardiness, surgeon arriving late was found to be the most prevalent. We analyzed the relationship between average minutes late each month and the cost and revenue per unit of service (UOS). Average minutes late per month and hospital revenue per UOS showed a strong inverse correlation of -0.83, while average minutes late per month and cost er UOS showed a moderate positive correlation of 0.62. We analyzed the relationship between average minutes late each month and the cost and revenue per UOS. Average minutes late per month and hospital revenue per UOS showed a strong inverse correlation of -0.83, while average minutes late per month and cost per UOS showed a moderate positive correlation of 0.62.Conclusions: Identifying causes of tardiness based on input from a multidisciplinary healthcare team and addressing each cause with a specific measure to combat it was effective in improving the percentage of on-time starts in the OR. We demonstrated that reducing delays in OR start times can both decrease cost and increase revenue. Documenting progress of efficiency measures is critical in distinguishing measures that work from those that do not. Furthermore, continued analysis of efficiency is required to maintain efficiency standards.