Effect of Individual Surgeons and Anesthesiologists on Operating Room Time

Abstract

BACKGROUND:: Variability in operating room (OR) time causes overutilization and underutilization of the available ORs. There is evidence that for a given type of procedure, the surgeon is the major source of variability in OR time. The primary aim was to quantify the variability between surgeons and anesthesiologists. As illustration, the value of modeling the individual surgeons and anesthesiologist for OR time prediction was estimated. METHODS:: OR data containing 16,480 cases were obtained from a general surgery department. The total amount of variability in OR time accounted for by the type of procedure, first and second surgeon, and the anesthesiologist was determined with the use of linear mixed models. The effect on OR time prediction was evaluated as reduction in overtime and idle time per case. RESULTS:: Differences between first surgeons can account for only 2.9% (2.0%–4.2%) of the variability in OR time. Differences between anesthesiologists can account for 0.1% (0.0%–0.3%) of the variability in OR time. Incorporating the individual surgeons and anesthesiologists led to an average reduction of overtime and idle time of 1.8 (95% confidence interval, 1.7–2.0, 10.5% reduction) minutes and 3.0 (95% confidence interval, 2.8%–3.2, 17.0% reduction) minutes, respectively. CONCLUSIONS:: In comparison with the type of procedure, differences between surgeons account for a small part of OR time variability. The impact of differences between anesthesiologists on OR time is negligible. A prediction model incorporating the individual surgeons and anesthesiologists has an increased precision, but improvements are likely too marginal to have practical consequences for OR scheduling.