Presented by: Arun Rai MD, MBA, MSc
Northwell Health

Introduction

Operating room (OR) utilization is a key component of economic considerations utilized by OR directors and hospital administrators. Case start times and turn over time can significantly impact OR utilization and overall economic efficiency. The OR Black Box® (ORBB) is a recording platform that integrates both audio and visual recordings of the operating room and procedure. We utilized information from the ORBB to identify factors that impact OR utilization as well as compliance with safety protocols. 

Materials

This is a prospective analysis of operating room utilization at a tertiary academic health center using a novel data capture device designed for use in the operating room. Information from the ORBB of three busy operating rooms were reviewed from February 7 to September 4 of 2022 to evaluate case on-time starts, block utilization, turnover time, and compliance with pre-procedural ‘time out’ safety checklist. Block utilization is defined as the time in which a patient is in the OR for the 9-hour block periods or is it “the sum of the time it takes to perform each surgical procedure plus the total turnover time, divided by the time available”. The turn-over times were compared to national averages provided by the ORBB platform. 

Results

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Data from 1342 cases were included for analysis. Average turnover time across the three ORs was 46 minutes, which is above the 38-minute national average for all ORs equipped with the ORBB. This increased turnover time equated to 30-31 hours of overtime, which at our institution amounts to approximately $1,460 of additional costs. On average, there was 67% block utilization time across the 3 ORs, which represents the amount of time that a patient is present in the OR. Cases started on time 68% of the time for all ORs, however when looking at urology cases only, cases started 100% on-time. From a safety checklist standpoint, 97% of cases had a time-out completed correctly per hospital policy. 

Conclusion

Data derived from the ORBB allows for assessment of OR utilization and adherence to safety protocols. This data is critical from a health management standpoint to ensure judicious use of hospital resources. Further data is needed to understand factors prolonging turn-over time at our institution as well as those preventing on-time start among services other than urology. Further data will need to evaluate factors enabling urology cases to achieve a 100% on-time start, such that other services can achieve similar rates. Ultimately improve OR block utilization.  

Funding

None

Lead Authors

Louis Kavoussi, MD, MBA
Northwell Health

Leah Beland, MD
Northwell Health