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Analysis to Establish Differences in Efficiency Metrics Between Operating Room and Non-Operating Room Anesthesia Cases

  • Systems-Level Quality Improvement
  • Published:
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Abstract

While a number of studies have examined efficiency metrics in the operating rooms (ORs), there are few studies addressing non-operating room anesthesia (NORA) metrics. The standards established in the realm of OR studies may not apply to ongoing investigations of NORA efficiency. We hypothesize that there are significant differences in these commonly used metrics. Using retrospective data from a single tertiary care hospital in the 2015 calendar year, we measured turnover times, cancellation rates, first case start delays, and scheduling error (actual time minus scheduled time) for the OR and NORA settings. On average, TOTs for NORA cases were approximately 50% shorter than OR cases (16.21 min vs. 37.18 min), but had a larger variation (11.02 min vs. 8.12 min). NORA cases were 64% as likely to be cancelled compared to OR cases. In contrast, NORA cases had an average first case start delay that was two times greater than that of OR cases (24.45 min vs. 10.58 min), along with over double the standard deviation (11.97 min vs. 5.90 min). Case times for NORA settings tended to be overestimated (−4.07 min versus −2.12 min), but showed less variation (8.61 min vs. 17.92 min). In short, there are significant differences in common efficiency metrics between OR and NORA cases. Future studies should elucidate and validate appropriate efficiency benchmarks for the NORA setting.

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Authors and Affiliations

  1. Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, 75 Francis Street, CWN L1, Boston, MA, 02115, USA

    Albert Wu & Richard D. Urman

  2. Department of Anesthesiology, University of Arkansas College of Medicine, Little Rock, AR, USA

    Joseph A. Sanford

  3. Department of Anesthesiology, University of Vermont Larner College of Medicine, Burlington, VT, USA

    Mitchell H. Tsai, Stephen E. O’Donnell & Billy K. Tran

  4. Department of Orthopaedics and Rehabilitation (by courtesy), University of Vermont Larner College of Medicine, Burlington, VT, USA

    Mitchell H. Tsai

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  1. Albert Wu
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  3. Mitchell H. Tsai
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  4. Stephen E. O’Donnell
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  6. Richard D. Urman
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Correspondence to Richard D. Urman.

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Albert Wu declares that he has no conflict of interest; Joseph A. Sanford declares that he has no conflict of interest; Mitchell H. Tsai declares that he has no conflict of interest; Stephen E. O’Donnell declares that he has no conflict of interest; Billy K. Tran declares that he has no conflict of interest; Richard D. Urman declares that he has no conflict of interest.

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This article does not contain any studies with human participants performed by any of the authors.

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This article is part of the Topical Collection on Systems-Level Quality Improvement

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Wu, A., Sanford, J.A., Tsai, M.H. et al. Analysis to Establish Differences in Efficiency Metrics Between Operating Room and Non-Operating Room Anesthesia Cases. J Med Syst 41, 120 (2017). https://doi.org/10.1007/s10916-017-0765-9

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  • DOI: https://doi.org/10.1007/s10916-017-0765-9

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