Dedicated operating room for emergency surgery generates more utilization, less overtime, and less cancellations.
BACKGROUND
Two approaches prevail for reserving operating room (OR) capacity for emergency surgery: (1) dedicated emergency ORs and (2) evenly allocating capacity to all elective ORs, thereby creating a virtual emergency team. Previous studies contradict which approach leads to the best performance in OR utilization.


METHODS
Quasi-experimental controlled time-series design with empirical data from 3 university medical centers. Four different time periods were compared with analysis of variance with contrasts.


RESULTS
Performance was measured based on 467,522 surgical cases. After closing the dedicated emergency OR, utilization slightly increased; overtime also increased. This was in contrast to earlier simulated results. The 2 control centers, maintaining a dedicated emergency OR, showed a higher increase in utilization and a decrease in overtime, along with a smaller ratio of case cancellations because of emergency surgery.


CONCLUSIONS
This study shows that in daily practice a dedicated emergency OR is the preferred approach in performance terms regarding utilization, overtime, and case cancellations.
Department of Operating Rooms, Erasmus University Medical Center Rotterdam, s-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands. Electronic address: e.berkx@erasmusmc.nl.
Elizabeth
E
van Veen-Berkx
Department of Health Care Logistics, Institute for Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
Sylvia G
SG
Elkhuizen
Department of Hospital & Health Care, Logex, Amsterdam, The Netherlands.
Bart
B
Kuijper
Department of Surgery, VU University Medical Center Amsterdam, Amsterdam, The Netherlands.
Geert
G
Kazemier
D000046:Academic Medical Centers / Q000458:organization & administration / Q000706:statistics & numerical data; D001071:Appointments and Schedules; D017598:Efficiency, Organizational; D004630:Emergencies; D004636:Emergency Service, Hospital / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D009426:Netherlands; D009873:Operating Rooms / Q000458:organization & administration* / Q000706:statistics & numerical data; D016134:Organizational Policy; D017064:Process Assessment, Health Care; D011446:Prospective Studies; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data*; D016526:Workload / Q000706:statistics & numerical data
Emergency surgery; Operating room capacity; Operating room utilization