Interchangeability of counts of cases and hours of cases for quantifying a hospital's change in workload among four-week periods of 1 year

Franklin Dexter, Richard H. Epstein, Johannes Ledolter, Jonathan P. Wanderer

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Study objective: Recent studies have made longitudinal assessments of case counts using State (e.g., United States) and Provincial (e.g., Canada) databases. Such databases rarely include either operating room (OR) or anesthesia times and, even when duration data are available, there are major statistical limitations to their use. We evaluated how to forecast short-term changes in OR caseload and workload (hours) and how to decide whether changes are outliers (e.g., significant, abrupt decline in anesthetics). Design: Observational cohort study. Setting: Large teaching hospital. Measurements: 35 years of annual anesthesia caseload data. Annual data were used without regard to where or when in the year each case was performed, thereby matching public use files. Changes in caseload or hours among four-week periods were examined within individual year-long periods using 159 consecutive four-week periods from the same hospital. Main results: Series of 12 four-week periods of the hours of cases performed on workdays lacked trend or correlation among periods for 49 of 50 series and followed normal distributions for 50 of 50 series. These criteria also were satisfied for 50 of 50 series based on counts of cases. The Pearson r = 0.999 between hours of anesthetics and cases. Conclusions: For purposes of time series analysis of total workload at a hospital within 1-year, hours of cases and counts of cases are interchangeable. Simple control chart methods of detecting sudden changes in workload or caseload, based simply on the sample mean and standard deviation from the preceding year, are appropriate.

Original languageEnglish (US)
Pages (from-to)118-125
Number of pages8
JournalJournal of Clinical Anesthesia
StatePublished - Sep 2018

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine


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