Study: Managing Variable OR Patient Flow Increases Prime Time Use 56%

A protocol to manage patient flow variability in an operating room led to increased prime time use and income, according to a study in the Journal of the American College of Surgeons.

Researchers analyzed data on two types of variation in a referral center's OR: natural variation such as unscheduled operations, which is uncontrollable; and artificial variation such as scheduled operations, which is controllable. The researchers developed mathematical models to determine resource allocation for each type of variation. The OR made the following changes:

•    Allocated block time based on 80 percent prime time use.
•    Established a 5 p.m. cap for all scheduled cases.
•    Implemented guidelines for OR access to minimize artificial variation on the day of surgery.

After one year, the OR saw the following improvements:

•    4 percent increase in surgical volume and 5 percent increase in surgical minutes.
•    56 percent increase in prime time use.
•    27 percent decrease in overtime staffing.
•    20 percent decline in day-to-day variability.
•    70 percent decrease in the number of elective schedule same-day changes.
•    41 percent decrease in staff turnover.
•    38 percent increase in net operating income and 28 percent increase in margin.

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