Dedicated operating room for emergency surgery generates more utilization, less overtime, and less cancellations

Abstract

Background: Two approaches prevail for reserving operating room (OR) capacity for emergency surgery: (1) dedicated emergency ORs and (2) evenly allocating capacity to all elective ORs, thereby creating a virtual emergency team. Previous studies contradict which approach leads to the best performance in OR utilization.

Methods: Quasi-experimental controlled time-series design with empirical data from 3 university medical centers. Four different time periods were compared with analysis of variance with contrasts.

Results: Performance was measured based on 467,522 surgical cases. After closing the dedicated emergency OR, utilization slightly increased; overtime also increased. This was in contrast to earlier simulated results. The 2 control centers, maintaining a dedicated emergency OR, showed a higher increase in utilization and a decrease in overtime, along with a smaller ratio of case cancellations because of emergency surgery.

Conclusion: This study shows that in daily practice a dedicated emergency OR is the preferred approach in performance terms regarding utilization, overtime, and case cancellations.

Keywords: Emergency surgery; Operating room capacity; Operating room utilization.