title: Operating room efficiency and hospital capacity: factors affecting operating room use during maximum hospital census.
abstract: BACKGROUND
  Academic medical centers are faced with increasing volumes, higher acuity, and, as a consequence, capacity issues. These affect operating room (OR) use and patient throughput, with negative impact on finances and patient and physician satisfaction. We evaluated our experiences in dealing with OR efficiency at a time of maximum hospital capacity and occupancy.
  
  
  METHODS
  Using a multidisciplinary approach, we put in place seven agreed-upon strategies: daily communication, improved bed planning, discharge by noon program, internal staffing pool, special assignments for a patient transition unit, incentives, and stepped up environmental services.
  
  
  RESULTS
  After institution of these strategies, we were able to realize a gain in OR patient volume of 8% and a decrease in OR holds of 37%. This resulted in a decrease in canceled OR cases from 4.3% to 3.1%.
  
  
  CONCLUSIONS
  Academic medical centers face occupancy issues that are not likely to go away and will have an impact on OR volume and productivity. To improve the situation in a short-term fashion, a multidisciplinary approach involving several strategies will be needed.
authors.affiliation: Health System Administration, University of Virginia Health Systems, Charlottesville, VA 22908, USA.
authors.forename: James E
authors.initials: JE
authors.lastname: McGowan
authors.forename: Jonathon D
authors.initials: JD
authors.lastname: Truwit
authors.forename: Pam
authors.initials: P
authors.lastname: Cipriano
authors.forename: R Edward
authors.initials: RE
authors.lastname: Howell
authors.forename: Margaret
authors.initials: M
authors.lastname: VanBree
authors.forename: Arthur
authors.initials: A
authors.lastname: Garson
authors.forename: John B
authors.initials: JB
authors.lastname: Hanks
mesh_terms: D000046:Academic Medical Centers / Q000458:organization & administration*; D003142:Communication; D017598:Efficiency, Organizational; D006742:Hospital Bed Capacity; D006801:Humans; D009042:Motivation; D009873:Operating Rooms / Q000706:statistics & numerical data*; D019982:Organizational Case Studies; D009937:Organizational Objectives; D010351:Patient Discharge; D010561:Personnel Staffing and Scheduling; D017064:Process Assessment, Health Care; D014768:Virginia