Evaluation of operating room suite efficiency in the Veterans Health Administration system by using data-envelopment analysis.
BACKGROUND
Operating room (OR) activity transcends single ratios such as cases/room, but weighting multiple inputs and outputs may be arbitrary. Data-envelopment analysis (DEA) is a novel technique by which each facility is analyzed by the weightings that optimize its score.


METHODS
We performed DEA analysis of 23 Veterans Health Administration annual OR activity; 87,180 cases were performed, 24 publications generated, and 560 trainee-years of education delivered, in 168 ORs over 166,377 hours by 1,384 full-time equivalents of surgical and anesthesia providers and 523 nonproviders.


RESULTS
Varying analyzed parameters produced similar efficiency rankings, with individual differences suggesting possible inefficiencies. We characterized returns to scale for efficient sites, suggesting whether patient flow might be efficiently further increased through these sites. We matched inefficient sites to similar efficient sites for comparison and suggested resource alterations to increase efficiency.


CONCLUSIONS
Broader DEA application might characterize OR efficiency more informatively than conventional single-ratio rank ordering.
Basson
Marc D
MD
Department of Surgery, John D. Dingell VA Medical Center and Wayne State University, 4646 John R. Street, Detroit, MI 48201-1932, USA. marc.basson@va.gov
Butler
Timothy
T
D000776:Anesthesiology / Q000193:education; D003661:Decision Support Techniques; D017598:Efficiency, Organizational; D013502:General Surgery / Q000193:education; D006787:Hospitals, Veterans / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D007396:Internship and Residency; D009873:Operating Rooms / Q000458:organization & administration* / Q000706:statistics & numerical data; D011382:Programming, Linear; D014481:United States; D014493:United States Department of Veterans Affairs