Increased OR Efficiency with Surgeon-Managed Orthopaedic Blocks

Abstract

Objectives: To analyze orthopaedic operative block time efficiency when scheduled by operating suite scheduling time versus dedicated group of orthopaedic surgeons and clinical leaders

Design: Retrospective Review

Setting: A Metropolitan Hospital

Patients/Participants: All operative orthopaedic cases that took place between August 2018 and February 2023 in four dedicated orthopaedic operating rooms

Intervention: Responsibility for OR schedule and block management was shifted into the hands of a dedicated group of orthopaedic surgeons and clinical leaders

Main Outcome Measurements: Number of cases per day, operative time per day, number of after-hours cases, scheduled case length accuracy

Results and Conclusions: On average, 13.4 ± 3.1 cases were done per day in the four orthopaedic ORs during the post-intervention (surgeon-scheduled) period compared to 11.3 ± 3.2 and 11.6 ± 2.8 in the pre-intervention and post-COVID periods, respectively (p < 0.001). Analysis of average percent deviation from scheduled time reveals a significantly lower average deviation during the post-intervention period (17.3 ± 19.3 %) when compared to the pre-intervention and post-COVID periods (18.7 ± 23.8% and 19.7 ± 24.0%, respectively; p = 0.003). Additionally, there was a greater than expected frequency of cases estimated accurately (within 10% of their actual operative time) during the post-intervention period (959, 45.1%; p<0.001). The present study demonstrates an average increase in the number of orthopaedic cases performed per day with subsequent decrease in proportion of after-hours case starts with surgeon responsibility for case scheduling.

Key Words: Operating room efficiency; Surgical case scheduling; Orthopaedic surgery blocks

Level of Evidence: Level IV