Operating Room Inefficiencies Attributable to Errors in Surgical Case Scheduling and Surgeon Procedure Heterogeneity. (November 2016)

• Record Type: Journal Article
• Authors: Pariser, Joseph J.; Diamond, Alanna J.; Christianson, Laura W.; Mitchell, Brian A.; Langerman, Alexander
• Is Part Of: American journal of medical quality. Volume 31:Number 6(2016:Nov./Dec.)
• Page Start: 584
• Page End: 588
• Publication Date: 2016-11
• Subjects: operating rooms -- efficiency -- staffing and scheduling -- operative time; Medical care -- Quality control -- Periodicals; Medical care -- Evaluation -- Periodicals; Medical care -- Utilization review -- Periodicals; Medical care -- United States -- Periodicals; 362.1
• DOI: 10.1177/1062860615606517
• Languages: English
• ISSNs: 1062-8606

Abstract

This study examined effects of scheduling errors on operating room efficiency and surgeon procedure heterogeneity on the rate of incorrectly scheduled cases. Operative cases in an academic center over 11 months were categorized as correctly or incorrectly scheduled. Surgeon heterogeneity was the number of unique procedures performed. Delays were greater for misbooked first cases (median 9 minutes late (interquartile range [IQR] 2-24) vs 4 (IQR 0-13), P < .01). For subsequent cases, turnover time was longer if misbooked (47 minutes (IQR 33-69) vs 39 (IQR 28-55), P < .01). Overall, the difference between actual and scheduled length was greater for misbooked cases (26 minutes (IQR −15 to +79) vs 6 (IQR −17 to +38), P < .01). Highest heterogeneity surgeons had higher risk of incorrect scheduling compared with the lowest (odds ratio = 1.97, 95% confidence interval [1.34-2.98], P < .01). Scheduling errors led to delays in first starts, unexpectedly longer cases, and prolonged turnovers. Highest heterogeneity surgeons were at greatest risk for misbooking.