title: Operating Room Inefficiencies Attributable to Errors in Surgical Case Scheduling and Surgeon Procedure Heterogeneity.
abstract: This study examined effects of scheduling errors on operating room efficiency and surgeon procedure heterogeneity on the rate of incorrectly scheduled cases. Operative cases in an academic center over 11 months were categorized as correctly or incorrectly scheduled. Surgeon heterogeneity was the number of unique procedures performed. Delays were greater for misbooked first cases (median 9 minutes late (interquartile range [IQR] 2-24) vs 4 (IQR 0-13), P < .01). For subsequent cases, turnover time was longer if misbooked (47 minutes (IQR 33-69) vs 39 (IQR 28-55), P < .01). Overall, the difference between actual and scheduled length was greater for misbooked cases (26 minutes (IQR -15 to +79) vs 6 (IQR -17 to +38), P < .01). Highest heterogeneity surgeons had higher risk of incorrect scheduling compared with the lowest (odds ratio = 1.97, 95% confidence interval [1.34-2.98], P < .01). Scheduling errors led to delays in first starts, unexpectedly longer cases, and prolonged turnovers. Highest heterogeneity surgeons were at greatest risk for misbooking.
authors.affiliation: University of Chicago, Chicago, IL pariserj@gmail.com.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Pariser
authors.affiliation: University of Chicago, Chicago, IL.
authors.forename: Alanna J
authors.initials: AJ
authors.lastname: Diamond
authors.affiliation: University of Chicago, Chicago, IL.
authors.forename: Laura W
authors.initials: LW
authors.lastname: Christianson
authors.affiliation: University of Chicago, Chicago, IL.
authors.forename: Brian A
authors.initials: BA
authors.lastname: Mitchell
authors.affiliation: University of Chicago, Chicago, IL.
authors.forename: Alexander
authors.initials: A
authors.lastname: Langerman
mesh_terms: D000046:Academic Medical Centers / Q000458:organization & administration; D017598:Efficiency, Organizational; D006801:Humans; D009873:Operating Rooms / Q000458:organization & administration*; D061646:Operative Time; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration*; D013514:Surgical Procedures, Operative / Q000379:methods / Q000706:statistics & numerical data*
keywords: efficiency; operating rooms; operative time; staffing and scheduling