[Operation room management: from degree of utilization to distribution of capacities. Cost reduction without decreasing productivity in the operation room using a new index].
BACKGROUND
The new index "degree of operation room (OR) utilization" describes the ratio between possible and actual OR utilization with purely surgical time. The possible OR utilization with purely surgical time was calculated by eliminating the time necessary for induction and emergence from anaesthesia, the time necessary for surgical measurements directly before the first incision (i.e. skin disinfection) and directly after the last suture (i.e. wound dressing) of an operation from the time an operating room could theoretically be used with purely surgical times (the theoretical block time). The possibility of distributing block time based on the effectiveness of surgeons and to reduce costs by identifying waste of block time was investigated using the "degree of OR utilization" method.


METHODS
Using our own anaesthesia data base with an average of 12,000 anaesthetic procedures per annum, the degree of OR utilization and the need for additional block time for each clinic performing operative procedures in the OR centre of the hospital were analyzed. The need for additional block time and the costs for additional OR staff (including anaesthesiologists and nurses) were then calculated in US dollars.


RESULTS
After redistribution it was possible to reduce the OR capacities and costs for OR staff (including anaesthesiologists and nurses) by a minimum of 280.142 US dollars per year.


CONCLUSIONS
The application of the new index "degree of OR utilization" enables the OR manager to distribute OR capacities to surgeons with effective use of block time. This leads to cost reduction without minimizing surgical productivity or income and therefore to a higher level of OR efficiency.
Grote
R
R
Klinik für Anästhesie, Operative Intensivmedizin und Rettungsmedizin, Klinikum der Stadt Wolfsburg. rolf.grote@klinikum.wolfsburg.de
Perschmann
S
S
Walleneit
A
A
Sedlacek
B
B
Leuchtmann
D
D
Menzel
M
M
D001071:Appointments and Schedules; D017046:Cost Savings; D003627:Data Interpretation, Statistical; D004526:Efficiency; D018803:Models, Economic; D015233:Models, Statistical; D009873:Operating Rooms / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data*; D010561:Personnel Staffing and Scheduling