Purpose
Operating room (OR) efficiency has an impact on surgeon productivity and patient experience.
Accuracy of case duration estimation is important to optimize OR efficiency. The purpose
of this study was to identify factors associated with inaccurate case time estimates
in outpatient hand surgery. A better understanding of these findings may help to improve
OR efficiency and scheduling.
Methods
All outpatient hand surgical cases from 2018 to 2019 were reviewed. Poorly-estimated
cases (i.e., poor scheduling accuracy) were defined as those cases where the actual
operative time differed from the predicted time by >50% (either quicker by >50% or
slower by >50% than the predicted time). The percentages of poorly-estimated cases
were analyzed, categorized, and compared by surgeon, procedure type, and scheduled
case length.
Results
A total of 6,620 cases were identified. Of 1,107 (16.7%) cases with poorly estimated
case durations, 75.2% were underestimated. There was no difference in the likelihood
of poor estimation related to start time. Well-estimated cases tended to have longer
scheduled case duration, but shorter realized case duration and surgical time. Our
systems analysis identified specific surgeons and procedures as predictable outliers.
Cases scheduled for 15–30 minutes frequently were inaccurate, whereas cases scheduled
for 30–45 and 106–120 minutes had accurate estimates.
Conclusions
The accuracy of case time estimations in a standard outpatient hand surgery practice
is highly variable. Nearly one-fifth of outpatient hand surgery case durations are
poorly estimated, and inaccurate case time estimation can be predicted based on surgeon,
procedure type, and case time.
Clinical Relevance
Maximizing OR efficiency should be a priority for surgeons and hospital systems. With
multiple surgeries done per day, the efficiency of the OR has an impact on surgeon
productivity and patient experience.
Key words
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Article info
Publication history
Published online: November 03, 2022
Accepted:
August 31,
2022
Received:
February 7,
2022
Publication stage
In Press Corrected ProofFootnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2022 by the American Society for Surgery of the Hand. All rights reserved.
