title: Scheduling surgical cases into overflow block time- computer simulation of the effects of scheduling strategies on operating room labor costs.
abstract: "Overflow" block time is operating room (OR) time for a surgical group's cases that cannot be completed in the regular block time allocated to each surgeon in the surgical group. Having such overflow block time increases OR utilization. The optimal way to schedule patients into a surgical group's overflow block time is unknown. In this study, we developed a scheduling strategy that balances the OR manager's need to reduce staffing costs and the needs of patients and surgeons for flexibility in choosing the dates and times of cases. We used computer simulation to evaluate our scheduling strategy. Surgeons and patients (i) can schedule the case into any overflow block within 2 wk; (ii) can only schedule the case into a "first case of the day" start time more than 2 wk in the future if there is not enough open time for the case within 2 wk; (iii) must schedule the case to be done within 4 wk; and (iv) are encouraged to perform the case on the earliest possible date. Staffing costs were lowest when the OR manager did not incorporate surgeon and patient preferences when scheduling cases into overflow block time. The strategy we developed provides surgeons and patients with some flexibility in scheduling, while only increasing OR staffing costs slightly over the minimum achieved when the OR manager controls scheduling.
  
  
  CONCLUSIONS
  The strategy we developed provides surgeons and patients with some flexibility in scheduling, while increasing OR staffing costs only slightly over the minimum achieved when the OR manager controls scheduling. Staffing costs were lowest when the operating room (OR) manager did not incorporate surgeon and patient preferences when scheduling cases into overflow block time.
authors.affiliation: Department of Anesthesia, University of Iowa, Iowa City, Iowa 52242, USA. franklin-dexter@uiowa.edu
authors.forename: F
authors.initials: F
authors.lastname: Dexter
authors.forename: A
authors.initials: A
authors.lastname: Macario
authors.forename: L
authors.initials: L
authors.lastname: O'Neill
mesh_terms: D001071:Appointments and Schedules; D003198:Computer Simulation; D003365:Costs and Cost Analysis; D006801:Humans; D009873:Operating Rooms; D013514:Surgical Procedures, Operative / Q000191:economics*; D013997:Time Factors