Case-to-Case Factors Affecting Operating Room Turnover Time
Andrew Z Mo, MD; Andrew Auerbach, MD; Daniel Polatsch, MD; Steven Beldner, MD
Lenox Hill Hospital, New York, NY
Background
In the present healthcare environment, it has become increasingly important to maximize efficiency and decrease unnecessary costs. One study estimated the average utilization cost of an operating room (OR) per minute to be $62.1 There are numerous factors affecting OR turnover time, with some studies having investigated several such as the effect of factors on turnover time, surgeon presence in the OR, level of case complexity, specific surgeons, and American Society of Anesthesiologists (ASA) class. Case-to-case laterality has not been studied in the literature to date. We hypothesized that ipsilateral procedure laterality between would decrease turnover time between procedures.
Methods
A total of 560 hand surgery procedures performed by 2 senior attending hand surgeons between May 2016 and January 2017 were identified. A retrospective review was performed, analyzing the turnover times between ipsilateral and contralateral sided procedures. Variables collected included turnover time, case complexity, surgical site laterality, utilization of implants, use of fluoroscopic imaging, and whether cases were performed before OR staff breaks. Case complexity was defined as either cases that involved multiple procedures or cases that involved the use of adjuncts such as microscopy or arthroscopy. An unpaired, two tailed t-test was used to assess the effects of multiple factors on turnover time.
Results
Of 486 eligible cases, the average turnover time was 29 minutes. Turnover time was significantly increased by whether the patient was in the room prior to staff break times (p<0.001), the use of arthroscopy (p<0.01), the use of fluoroscopic imaging (p<0.02), and increased case complexity (p<0.04). Factors that did not affect turnover time were gender (p<0.86), case-to-case laterality (p<0.59), surgeon identity (p < 0.40), the OR (p < 0.07), and dedicating an OR to one side (p<0.21).
Conclusion
Case-to-case laterality does not appear to affect OR turnover time. In light of the significance of turnover time differences pre- and post-staff breaks, one may benefit from booking smaller procedures earlier in the day prior to staff breaks to maximize efficiency.
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