5 of the Most Important Operating Room Performance Metrics

Operating room resources are the most valuable in a hospital setting. Estimates show that the cost of an operating room stands at $30 to $100 per minute. The high cost is just one reason hospitals and ASCs must continuously assess the efficiency of a hospital’s OR and related resources. However, you must know which metrics to track to gauge the efficiency of your OR.

There’s just one catch. Your metrics will only be as good as your data. Many healthcare practices increasingly rely on scheduling software to capture important data accurately.

Let’s examine the most important operating room utilization metrics and what they mean for your practice.

OR Utilization Metric #1: First Cast Start Time

The first case on-time/early measures the number of first cases daily that begin either before or within 5 minutes of the scheduled start time. Often, delays at the beginning of the day trickle downwards to cause delays in subsequent cases. This decreases customer satisfaction (patients have to wait if preceding cases run late) and delays compound as the day goes on, decreasing OR resource efficiency.

For optimal OR utilization, delays in start times of both first and subsequent scheduled cases should not exceed 45 minutes for every eight-hour window of OR time. The OR manager can improve efficiency of ORs using surgery scheduling software and communicating with patients in real-time to make any appropriate changes. These include:

  • Communicating delays to patients and assigning new time slots ASAP after a significant delay occurs, e.g., following a challenging surgery that required more time than anticipated
  • Scheduling a small window between consecutive cases to allow delays
  • Moving cases among ORs that are free when one procedure runs late
  • Placing surgeons in time blocks so that they handle all/most of their cases within the same OR to save time
  • Beginning with the most predictable cases in the morning and end with the least predictable ones

The First-Case-On-Time metric cannot be observed in isolation. It is best observed in context with related operating room utilization benchmarks. Other significant metrics include the subsequent case early/on-time metric and the prime-time utilization (defined as the volume of cases between 7 a.m. and 4 p.m. that begin early or within 15 minutes of the scheduled start time.)

OR Utilization Metric #2: Turnover Times

Turnover time refers to the window between consecutive OR cases – from when a patient exits an OR to when the next patient enters. Turnover times usually take anywhere from 15 to 40 minutes. One operating room utilization benchmarking survey showed that the median OR turnover time was 28.5 minutes.

To improve turnover times, having accurate case duration data is a necessity. This metric measures the percentage of cases where patients’ case durations fell within 15 minutes of the estimated time. Using surgery scheduling software, this data is also useful for refining estimates according to procedure complexity and individual surgeon tendencies. It may also be useful to track patient-in-to-incision time and last-incision-closed-to-patient exit times to see where improvement is necessary.

Decreasing turnover time must be done with surgeons’ preferences in mind, as turnover times are a key satisfaction metric for surgeons and OR staff. Note that turnover time cannot refer to delays between cases, such as what happens when one surgeon finishes much earlier than estimated and the next surgeon and/or patient is unavailable to utilize the newly open time window.

OR Utilization Metric #3: Complications and Outcomes

Complications and Outcomes are two important operating room performance metrics. Naturally, they reflect how well your facility provides services to both clients and staff.

It’s critical to track complications of all kinds to determine the root cause. For example, it may be necessary to hold patients in the recovery room for longer after certain procedure to prevent nausea and vomiting or other undesirable symptoms.

Outcomes of surgical procedures can be tracked using software by provider/surgeon and by procedure. The former provides information on areas that a surgeon/anesthesiologist can improve, while the latter can improve systemic efficiency according to the type of procedure in question.

Tracking down insights from this metric represents an arduous yet worthwhile endeavor. For every complication, verifying where responsibility lies – within the system, people involved, or circumstances beyond control – is the only way to obtain information that can help your practice use this metric to make the necessary improvements.

OR Utilization Metric #4: Use of Block Scheduling

High-volume physicians and specialties thrive when well-managed blocks of time are assigned to them. Poor block scheduling creates gaps that decrease performance and productivity. Some practices allocate OR blocks by services rather than surgeons, and these must be carefully managed to decrease inefficiencies. For instance, if a procedure ends early, the subsequent case surgeon should be on-hand to take advantage of the time savings.

Whether by service or surgeon, the OR manager can use surgery scheduling software data to decrease turnover times and win valuable time savings that can then be reassigned to cases on the waiting list. Note that facilities with more ORs often show less efficient use of OR resources. According to this OR utilization benchmarks survey, U.S. ambulatory surgery centers (ASCs) have 10 percent less scheduling accuracy than Canadian ASCs and 15 minutes more average turnover time.

OR Utilization Metric #5: Cancellation Rates

The time lost because of cancellations can critical to OR utilization. In one OR Manager Report, "cancellation rate was 1.7% for hospitals and 1.0% for ASCs. On average, hospital ORs lost 19 hours of surgery time per month because of cancellations, while ASCs on average lost 5 hours per month.” Using surgery scheduling software that can aid staff in responding quickly to cancellations, including those that happen in the days leading up to the surgery date, with real-time data and built-in communication features can help mitigate the cost of cancellations.

Transform Data Into Useful Metrics for Improvement

There are many more operating room performance metrics that ASCs and hospitals should track to ensure efficient use of OR resources including room, supplies, and staff. It can be tricky to bring together all the variables to maintain optimal efficiency, which is where robust surgery scheduling software comes in.

CaseCTRL is a surgery scheduling software created by surgeons for surgeons. Using AI capabilities and other features, you can continuously apply insights from CaseCTRL to improve service delivery, efficiency, and employee and patient satisfaction. In this way, you run a safe, productive, and efficient OR in every respect. CaseCTRL does not replace your existing OR management console but augments its capabilities with tools designed to supercharge your surgery scheduling processes.

Contact us to get a demo or learn more about what CaseCTRL software can do for your practice.

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