Estimation of the duration of three common spine procedures as a tool for operating room utilization

Background: Operating room (OR) utilization is the ratio of total hours of elective cases divided by the number of hours the OR is staffed. Suboptimal OR utilization wastes medical resources, increases overall cost to healthcare organizations and ultimately insurance carriers. Accurate OR case length estimates are an essential component of optimizing OR utilization. The objective of the study is to evaluate the accuracy of spine surgeons, anesthesiologists, and OR nurse managers as compared to a computerized scheduling system when estimating the time needed to perform three common spine procedures. A secondary goal is to evaluate if there is a difference in how providers interpret “OR time needed” when making their estimations. We hypothesize that surgeons are less accurate than OR nurse managers and anesthesiologists when estimating OR time. Methods: Spine surgeons, anesthesiologists, and OR nurse managers at a single, tertiary academic institution were provided a survey to estimate the OR time needed to perform three common spine procedures. OR nurse managers and anesthesiologists were further asked to provide estimates based on the surgeon performing the procedure. Their predictions were then compared to the actual recorded times (averaged for the last 20 consecutive cases of each procedure done by each surgeon) and to the time predicted by the computerized scheduling system at our institution. The estimations provided by the surgeons were compared against their own recorded times. Patient and surgery data were collected to perform a secondary analysis to determine factors that may have significantly affected the prediction. Predictions within 30 minutes of the actual recorded time were defined as accurate. Results: Fourteen providers completed the survey. The group was composed of 5 orthopaedic surgeons, 3 neurosurgeons, 3 anesthesiologists, and 3 OR nurse managers. The estimates provided by anesthesiologists and surgeons were closer to the surgical control time (SCT) while the estimate provided by OR nurse managers was closer to the total OR time (TORT) for the three procedures evaluated. Although the computer system estimations were closer to both, mean SCT and mean TORT, it was not able to accurately schedule most cases (<50% of cases were scheduled within 30 minutes of the actual recorded times Conclusions: Surgeon's and Anesthesiologists estimates were closer to the SCT while the estimate of the OR nurse managers was closer to TORT. Although the computer scheduling system's average scheduling time was close to the actual OR time, its ability to accurately individual cases could be improved.

Duke Scholars

Author Olumide Ayodele Danisa Orthopaedic Surgery