Discrepancies Between Planned and Actual Operating Room Turnaround Times at a Large Rural Hospital in Germany

Advances in Knowledge

* - This study identified significant discrepancies between planned and actual operating room (OR) turnaround times at a large rural hospital in Northern Germany.

Application to Patient Care

* - The findings of the current study could potentially be used to improve OR planning and management and provide a reference point for optimal OR turnaround times. The correction of any discrepancies between planned and actual OR turnaround times can reduce patient wait times and increase OR optimisation by allowing more surgeries to be performed in a specific OR.

Organisational decisions related to the planning of surgeries are based on a series of hierarchical priorities, including patient safety, the surgeon’s access to an available operating room (OR), OR efficiency and patient wait times.¹ In contrast, longer-term strategic decisions focus on increasing OR capacity utilisation despite potential uncertainties in future caseloads.² The interval between the end of one surgery on a patient and the beginning of the next surgery on another patient is known as the OR turnaround time; this should be distinguished from OR turnover time which conventionally indicates the interval between the previous patient leaving the OR and the next patient entering the room, although these terms are sometimes used interchangeably.^3–6

Various factors have been shown to influence OR turnaround times; for example, the time of day of the surgery, the age and American Society of Anesthesiology physical status of the patient and the assignment of the right anaesthesiologist to a surgeon have all been associated with a reduction in OR overutilisation.^4,5,7,8 In contrast, a change in surgeon has been found to have no significant impact on OR efficiency.⁹ In an in-depth analysis of OR data, including causes of delays and personal accountability, Overdyk et al. found that teamwork improved OR efficiency.¹⁰ However, Masursky et al. observed that both surgeons and, to a lesser extent, anaesthesiologists, judged OR turnaround times according to mental models of factors influencing turnover; thus, the perceptions of surgeons or anaesthesiologists should not be relied upon to make OR management decisions.¹¹ A direct comparison between planned and actual OR turnaround times is useful as any discrepancies between the two times can affect OR efficiency. To this end, the current study...