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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