Making management decisions on the day of surgery based on operating room efficiency and patient waiting times

Anesthesiology

Volumn 101, Issue 6, 2004, Pages 1444-1453

  Dexter, Franklin ^a   Epstein, Richard H ^b,c   Traub, Rodney D ^d   Xiao, Yan ^e  

^a UNIVERSITY OF IOWA   (United States)

^b THOMAS JEFFERSON UNIVERSITY   (United States)

^c Medical Data Applications Ltd   (United States)

^d NORTH DAKOTA STATE UNIVERSITY   (United States)

^e UNIVERSITY OF MARYLAND SCHOOL OF MEDICINE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ANESTHESIST; COST MINIMIZATION ANALYSIS; DATA ANALYSIS; HOSPITAL INFORMATION SYSTEM; HOSPITAL MANAGEMENT; HOSPITAL UTILIZATION; HUMAN; INFORMATION RETRIEVAL; MEDICAL ASSESSMENT; MEDICAL DECISION MAKING; MEDICAL LITERATURE; MEDICAL STAFF; OPERATING ROOM; PRIORITY JOURNAL; REVIEW; SURGICAL WARD;

EID: 9444221371     PISSN: 00033022     EISSN: None     Source Type: Journal    
DOI: 10.1097/00000542-200412000-00027     Document Type: Review

References (48)

1. Dexter F, Macario A, Traub RD: Which algorithm for scheduling add-on elective cases maximizes operating room utilization? Use of bin packing algorithms and fuzzy constraints in operating room management. ANESTHESIOLOGY 1999; 91:1491-500
2. Kennedy MH: Bin-packing, Knapsack, and Change-constrained Approaches to Operating Room Scheduling (dissertation). Troy, New York, Rensselaer Polytechnic Institute, Department of Decision Sciences and Engineering Systems, 1992, pp 24, 83, 84, 99
3. Ozkarahan I: Allocation of surgical procedures to operating rooms. J Med Sys 1995; 19:333-52
4. McQuarrie DG: Limits to efficient operating room scheduling. Archiv Surg 1981; 116:1065-71
5. Dexter F, Traub RD: How to schedule elective surgical cases into specific operating rooms to maximize the efficiency of use of operating room time. Anesth Analg 2002; 94:933-42
6. Dexter F, Macario A, Traub RD: Optimal sequencing of urgent surgical cases scheduling cases using operating room information systems. J Clin Monit 1999; 15:153-62
7. Zhou J, Dexter F: Method to assist in the scheduling of add-on surgical cases: Upper prediction bounds for surgical case durations based on the log normal distribution. ANESTHESIOLOGY 1998; 89:1228-32
8. Dexter F, Traub RD, Lebowitz P: Scheduling a delay between different surgeons' cases in the same operating room on the same day using upper prediction bounds for case durations. Anesth Analg 2001; 92:943-6
9. Dexter F, Smith TC, Tatman DJ, Macario A: Physicians' perceptions of minimum time that should be saved to move a surgical case from one operating room to another: Internet-based survey of the Association of Anesthesia Clinical Directors' (AACD) members. J Clin Anesth 2003; 15:206-10
10. Dexter F: A strategy to decide whether to move the last case of the day in an operating room to another empty operating room to decrease overtime labor costs. Anesth Analg 2000; 91:925-8
11. Dexter F, Macario A, O'Neill L: A strategy for deciding operating room assignments for second-shift anesthetists. Anesth Analg 1999; 89:920-4
12. Dexter F, Traub RD: Sequencing cases in operating rooms: Predicting whether one surgical case will last longer than another. Anesth Analg 2000; 90:975-9
13. Lebowitz P: Schedule the short procedure first. AORN J 2003; 78:651-8
14. Dexter F, Traub RD: Statistical method for predicting when patients should be ready on the day of surgery. ANESTHESIOLOGY 2000; 93:1107-14
15. Dexter F, Macario A, Qian F, Traub RD: Forecasting surgical groups' total hours of elective cases for allocation of block time: Application of time series analysis to operating room management. ANESTHESIOLOGY 1999; 91:1501-8
16. Strum DP, Vargas LG, May JH: Surgical subspecialty block utilization and capacity planning: A minimal cost analysis model. ANESTHESIOLOGY 1999; 90:1176-85
17. Epstein RH, Dexter F: Statistical power analysis to estimate how many months of data are required to identify operating room staffing solutions to reduce labor costs and increase productivity. Anesth Analg 2002; 94:640-3
18. Dexter F, Epstein RH, Marsh HM: Statistical analysis of weekday operating room anesthesia group staffing at nine independently managed surgical suites. Anesth Analg 2001; 92:1493-8
19. Strum DP, Vargas LG, May JH, Bashein G: Surgical suite utilization and capacity planning: A minimal cost analysis model. J Med Syst 1997; 21:309-22
20. Dexter F, Traub RD, Macario A: How to release allocated operating room time to increase efficiency: Predicting which surgical service will have the most under-utilized operating room time. Anesth Analg 2003; 96:507-12
21. Dexter F, Macario A: Changing allocations of operating room time from a system based on historical utilization to one where the aim is to schedule as many surgical cases as possible. Anesth Analg 2002; 94:1272-79
22. Tessler MJ, Kleiman SJ, Huberman MM: A "zero tolerance for overtime" increases surgical per case costs. Can J Anaesth 1997; 44:1036-41
23. Dexter F, Blake JT, Penning DH, Lubarsky DA: Calculating a potential increase in hospital margin for elective surgery by changing operating room time allocations or increasing nursing staffing to permit completion of more cases: A case study. Anesth Analg 2002; 94:138-42
24. Macario A, Dexter F, Traub RD: Hospital profitability per hour of operating room time can vary among surgeons. Anesth Analg 2001; 93:669-75
25. Dexter F, Traub RD, Qian F: Comparison of statistical methods to predict the time to complete a series of surgical cases. J Clin Monit 1999; 15:45-51
26. Wright IH, Kooperberg C, Bonar BA, Bashein G: Statistical modeling to predict elective surgery time. ANESTHESIOLOGY 1996; 85:1235-45
27. Sorge M: Computerized O.R. scheduling: Is it an accurate predictor of surgical time? Can Oper Room Nurs J 2001; 19:7-18
28. Lebowitz P: Why can't my procedures start on time? AORN J 2003; 77:594-7
29. Zhou J, Dexter F, Macario A, Lubarsky DA: Relying solely on historical surgical times to estimate accurately future surgical times is unlikely to reduce the average length of time cases finish late. J Clin Anesth 1999; 11:601-5
30. Dexter F, Abouleish AE, Epstein RH, Whitten CW, Lubarsky DA: Use of operating room information system data to predict the impact of reducing turnover times on staffing costs. Anesth Analg 2003; 97:1119-26
31. Dexter F, Macario A, Lubarsky DA, Burns DD: Statistical method to evaluate management strategies to decrease variability in operating room utilization: Application of linear statistical modeling and Monte-Carlo simulation to operating room management. ANESTHESIOLOGY 1999; 91:262-74
32. Dexter F, Traub RD, Fleisher LA, Rock P: What sample sizes are required for pooling surgical case durations among facilities to decrease the incidence of procedures with little historical data? ANESTHESIOLOGY 2002; 96:1230-6
33. Dexter F, Macario A: What is the relative frequency of uncommon ambulatory surgery procedures in the United States with an anesthesia provider? Anesth Analg 2000; 90:1343-7
34. Weiss EN: Models for determining estimated start times and case orderings in hospital operating rooms. IIE Transactions 1990; 22:143-50
35. Dexter F, Ledolter H:. Managing risk and expected financial return from selective expansion of operating room capacity: Mean-variance analysis of a hospital's portfolio of surgeons. Anesth Analg 2003; 97:190-5
36. Strum DP, Sampson AR, May JH, Vargas LG: Surgeon and type of anesthesia predict variability in surgical procedure times. ANESTHESIOLOGY 2000; 92:1454-66
37. Macario A, Dexter F: Estimating the duration of a case when the surgeon has not recently performed the procedure at the surgical suite. Anesth Analg 1999; 89:1241-5
38. Opit LJ, Collins REC, Campbell G: Use of operating theatres: The effects of case-mix and training in general surgery. Ann R Coll Surg Engl 1991; 73:389-93
39. Strum DP, May JH, Sampson AR, Vargas LG, Spangler WE: Estimating times of surgeries with two component procedures: Comparison of the lognormal and normal models. ANESTHESIOLOGY 2003; 98:232-40
40. Hancock WM, Walter PF, More RA, Glick ND: Operating room scheduling data base analysis for scheduling. J Med Syst 1988; 12:397-409
41. Shukla RK, Ketcham JS, Ozcan YA: Comparison of subjective versus data base approaches for improving efficiency of operating room scheduling. Health Serv Manag Res 1990; 3:74-81
42. Staudte RG, Sheather SJ: Robust Estimation and Testing. New York, John Wiley & Sons, 1990, pp 105, 119, 120
43. Klugman SA, Panjer HH, Wilmot GE: Loss Models: From Data to Decisions. New York, John Wiley & Sons, 1998, pp 74, 75, 327, 583
44. Johnson NL, Kotz S, Balakrishnan N: Continuous Univariate Distributions, 2nd edition. Vol 1. New York, John Wiley & Sons, 1994, pp 241
45. Law AM, Kelton WD: Simulation Modeling and Analysis, 2nd edition. New York, McGraw-Hill, 1991, pp 335, 337
46. Dahiya RC, Guttman I: Shortest confidence and prediction intervals for the log-normal. Can J Stat 1982; 10:277-91
47. Strum DP, May JH, Vargas LG: Modeling the uncertainty of surgical procedure times: Comparison of the log-normal and normal models. ANESTHESIOLOGY 2000; 92:1160-7
48. Hahn GJ, Meeker WQ: Statistical Intervals: A Guide for Practitioners. New York, John Wiley & Sons, 1991, pp 31, 92-6