Managing Operating Room Cost in Cardiac Surgery with Three Process Interventions

Abstract

Healthcare providers in both public and private sectors are facing increasing pressure to improve their cost efficiency and productivity. The increasing cost of new technological solutions has enforced to apply operations management techniques developed for industrial and service processes. Meyer’s (2004) review of existing research shows that, on average, operating rooms (ORs) operate only at 68% of capacity. Using OR time efficiently is especially challenging when long operations are scheduled to fixed OR block time. This situation is typical in open heart surgeries, where a high variability in the length of required OR time combined with four and a half hour average OR time duration makes scheduling two operations during a normal eight hour workday difficult. The objective of this paper is to analyze the effect that three different process interventions have on the OR cost in OR performing open heart surgeries. The investigated process interventions are 4 days OR week (4D), the better accuracy of operating room time forecast (F) and doing anesthesia induction outside the OR (I). These interventions were emerged from practical organization context. This paper is organized as follows. First we provide a review of the existing literature on measures of OR utilization and investigated three interventions. Based on existing literature we construct a simulation model to test the interventions’ effect on OR utilization. Conclusions of results are presented and practical implications and new contribution to existed theory of operating room management is discussed.

Key Terms in this Chapter

Slack Time: Time operating room is empty at the end of regular hours.

Operating Time: Time patient is in the operating room during regular hours.

Anesthesia Induction: Time when the anesthesiologist begins the administration of agents intended to provide the level of anesthesia required for the scheduled procedure.

Discrete Event Simulation: A simulation model where significant changes occur at discrete time instances.

Overtime: Time that patient is in the operating room after regular hours.

Planning Slack Time: Minimum time that has to be left nonscheduled at the end of regular hours.