Operating Room Efficiency and Hospital Capacity: Factors Affecting Operating Room Use During Maximum Hospital Census - 19/08/11

Doi : 10.1016/j.jamcollsurg.2007.01.052

James E. McGowan, DHA , Jonathon D. Truwit, MD ^†,^§, Pam Cipriano, RN, PhD , R. Edward Howell, MS , Margaret VanBree, MHA, DrPh , Arthur Garson, MD, MPH ^§, John B. Hanks, MD, FACS ^‡,^⁎
Health System Administration, University of Virginia Health Systems, Charlottesville, VA
^† Division of Pulmonary Medicine, Department of Medicine, University of Virginia Health Systems, Charlottesville, VA
^‡ Division of General Surgery, Department of Surgery, University of Virginia Health Systems, Charlottesville, VA
^§ Office of the Dean, UVA School of Medicine, University of Virginia Health Systems, Charlottesville, VA
Office of the CEO, University of Virginia Health Systems, Charlottesville, VA.

Correspondence address: John B Hanks, MD, FACS, Box 800709, Department of Surgery, University of Virginia Medical Center, Charlottesville, VA 22908.

Résumé

Background

Academic medical centers are faced with increasing volumes, higher acuity, and, as a consequence, capacity issues. These affect operating room (OR) use and patient throughput, with negative impact on finances and patient and physician satisfaction. We evaluated our experiences in dealing with OR efficiency at a time of maximum hospital capacity and occupancy.

Study Design

Using a multidisciplinary approach, we put in place seven agreed-upon strategies: daily communication, improved bed planning, discharge by noon program, internal staffing pool, special assignments for a patient transition unit, incentives, and stepped up environmental services.

Results

After institution of these strategies, we were able to realize a gain in OR patient volume of 8% and a decrease in OR holds of 37%. This resulted in a decrease in canceled OR cases from 4.3% to 3.1%.

Conclusions

Academic medical centers face occupancy issues that are not likely to go away and will have an impact on OR volume and productivity. To improve the situation in a short-term fashion, a multidisciplinary approach involving several strategies will be needed.

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Abbreviations and Acronyms : DBN, OR, PACU, PTU