The impact of service-specific staffing, case scheduling, turnovers, and first-case starts on anesthesia group and operating room productivity: A tutorial using data from an Australian hospital

Catherine McIntosh, Franklin Dexter, Richard H. Epstein

Research output: Contribution to journalArticlepeer-review

251 Scopus citations

Abstract

BACKGROUND: In this tutorial, we consider the impact of operating room (OR) management on anesthesia group and OR labor productivity and costs. Most of the tutorial focuses on the steps required for each facility to refine its OR allocations using its own data collected during patient care. METHODS: Data from a hospital in Australia are used throughout to illustrate the methods. OR allocation is a two-stage process. During the initial tactical stage of allocating OR time, OR capacity ("block time") is adjusted. For operational decision-making on a shorter-term basis, the existing workload can be considered fixed. Staffing is matched to that workload based on maximizing the efficiency of use of OR time. RESULTS: Scheduling cases and making decisions on the day of surgery to increase OR efficiency are worthwhile interventions to increase anesthesia group productivity. However, by far, the most important step is the appropriate refinement of OR allocations (i.e., planning service-specific staffing) 2-3 mo before the day of surgery. CONCLUSIONS: Reducing surgical and/or turnover times and delays in first-case-of-the-day starts generally provides small reductions in OR labor costs. Results vary widely because they are highly sensitive both to the OR allocations (i.e., staffing) and to the appropriateness of those OR allocations.

Original languageEnglish (US)
Pages (from-to)1499-1516
Number of pages18
JournalAnesthesia and analgesia
Volume103
Issue number6
DOIs
StatePublished - Dec 2006
Externally publishedYes

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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