Studying Operating Room Utilization at Cardiothoracic Hospital, Ain Shams University

Abstract

Running an operating room (OR) is a very expensive process. In hospitals of the united states it is estimated that one minute of operating room time costs 62$ (Shippert, 2005). Meanwhile, OR revenue represent the biggest share in hospital revenue, hence come the importance of proper OR management (Marjamaa et al., 2008). One of the goals of OR management is proper OR utilization which is classically defined as “the ratio of the total OR time used to the total OR time allocated or budgeted” (Strum et al., 1999).. Strum and his colleagues also defined both concepts of “overutilization” and “underutilization” (Strum et al., 1999). Each of under- and overutilization affect the economic efficiency of OR, and thus utilization is targeted to be 85%. However, in complex OR it may be less (Tyler et al., 2003). Arcidiacono et al. 2015, identified seven important factors that affect OR utilization; (1) Workday of surgery: due to different schedule of each day. (2) Block utilization: it is expected that actual utilization is high if block utilization is found to be high. (3) First-case delay: which is the difference between the scheduled and the actual start time of the first case, it results in underutilization. (4) Cancellation hours; usually this result in underutilization, (5) Total same-day add-on case duration and number of add-ons: opposite to cancellation, this may result in overutilization. (6) Number of turnovers and turnover duration: long turnover increases adjusted utilization. (7) Number of completed cases: The more cases are scheduled; the more OR prime hours are filled. Services to patients cannot be improved if operating theatres are seen in isolation. The patient’s pathway to his surgery is complex and passes through many stages. Thus, Improving OR performance must consider a wider system, from the decision of surgery to the discharge planning. This requires quality oriented and committed leadership with the authority to make changes based upon high quality data on OR performance, effective communication and co-ordination between