[Quality of OR planning. Avoiding operating room underutilization or overutilization]. / Qualität der OP-Planung. Vermeidung von Unter- oder Uberauslastung des OP-Bereiches.

BACKGROUND: Accurate scheduling of operations is essential for an efficiently used OR. The aim of this investigation was to describe the quality of OR scheduling in the analyzed OR. Furthermore suggestions for avoiding underutilization or overutilization through optimized OR planning should be addressed if possible. METHODS: The planned duration, the real duration and the differences in minutes of 10,831 operations were analyzed. The statistical distribution was determined and the median, the quartiles, the interquartile range and the number of operations with a real duration lasting longer than planned were calculated. All operations were grouped in ascending order from the shortest planned duration. All planning groups were analyzed statistically and the results were compared. RESULTS: The planned OR durations did not show a normal distribution and 34% of all operations showed a real duration lasting longer than planned. The median of the differences was 10 min indicating that 50% of all operations were finished within 10 min earlier than planned. Operations with planned longer durations (>150 min) showed significantly more frequently a real duration lasting longer than planned. Furthermore, the differences between planned and real durations were additionally larger when planned durations were longer than 150 min. CONCLUSION: Prognosis of operations with longer planned duration (>150 min) should be improved in the OR area analyzed. Scheduling of these operations at the beginning of the OR list or with a sufficient time interval towards the end of the appointed OR block time within the OR list can avoid or at least minimize underutilization and overutilization of the OR.

[Operation room management: from degree of utilization to distribution of capacities. Cost reduction without decreasing productivity in the operation room using a new index]. / OP-Management: Vom "Nutzungsgrad-Schnitt-Naht-Zeit" zur OP-Tisch-Verteilung : Kostensenkung ohne Leistungsminderung im OP-Bereich mit einer neuen Kennzahl.

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.