A Time-Cost Analysis of Operating Room Utilization and Efficiency in Cardiac Surgery.

Abstract

Aims/Background The aim of this analysis was to determine Operating Room (OR) utilization efficiencies and costs in cardiac surgery. Methods A retrospective cohort of 1987 cardiac surgeries were analyzed over a 2-year period for surgeon idling time, knife-to-skin time, procedure time, total operation time and transfer times in a two-case/block model. Predefined indices of operational efficiency (Index of Operational Efficiency [InOE], Surgical Index of Operational Efficiency [sInOE]) were calculated for various procedures and teams. The goodness of fit of regression curves were performed for InOE for various times on the operational pathway. Results The mean 'procedure time' was 246 ± 73 minutes (78% of total OR time). OR utilization efficiencies were highest for aortic valve replacement (AVR) and coronary artery bypass surgery (CABG) and least for complex aortic procedures. Significant differences existed for procedure-specific and team-specific OR times and operational efficiency. Procedure times correlated strongest with InOE (r = -0.940, p < 0.001). They had a closer linear fit to regression curve analysis thus indicating greater efficiency. Conclusion There were significant variations between OR times and efficiencies for procedures and teams. Significant cost savings are possible by increasing efficiency along the operational pathways in cardiac surgery theatres.