Literature search for healthcare management decision-making on how to increase productivity by performing more surgical cases in the same staffed time

F Dexter; M Á Gómez-Ríos; R H Epstein

doi:10.1016/j.redare.2024.501656

Literature search for healthcare management decision-making on how to increase productivity by performing more surgical cases in the same staffed time

Rev Esp Anestesiol Reanim (Engl Ed). 2024 Dec 16:501656. doi: 10.1016/j.redare.2024.501656. Online ahead of print.

Authors

F Dexter¹, M Á Gómez-Ríos², R H Epstein³

Affiliations

¹ Professor and Director of the Division of Management Consulting, Department of Anesthesia, University of Iowa, Iowa City, Iowa, United States. Electronic address: Franklin-Dexter@UIowa.edu.
² Consultant Anesthesiologist, Complejo Hospitalario Universitario A Coruña, Coruña, Galicia, Spain.
³ Professor of Clinical Anesthesiology and Director of Perioperative Analytics, Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami, Miami, Florida, United States.

PMID: 39694265
DOI: 10.1016/j.redare.2024.501656

Abstract

This report shows an example of using literature search for healthcare management decision making, specifically, how anesthesiologists can enhance operating room (OR) productivity. A search was conducted using Scopus to gather relevant research on increasing surgical case numbers. References and citations were then examined. The search identified strategies to reduce non-operative times, facilitate overlapping surgeries, and optimize OR scheduling. Key findings indicate that reducing anesthesia-controlled times alone is insufficient to reliably add extra surgical cases within an eight-hour workday. Instead, significant productivity gains are realized by managing OR turnover times, using induction rooms, and revising workflows to maximize efficiency. Studies show that overlapping surgeries and strategic use of adjacent spaces can significantly increase the number of daily surgical cases performed. Most surgical growth is driven by accommodating low caseload surgeons across multiple specialties. Facilitating OR time access for these surgeons through flexible scheduling and re-sequencing of cases is crucial. Additionally, anesthesiologists should be engaged in daily OR scheduling and case sequencing, particularly within two days of surgery. The dual goals are to increase OR utilization and reduce patient wait times. These results from the management case report underscores the importance of evidence-based OR management practices and proactive involvement of anesthesiologists in scheduling decisions to enhance surgical productivity effectively.

Keywords: Anesthesia-controlled time; Búsqueda de operaciones; Epidemiología gerencial; Gestión del quirófano; Industrial engineering; Ingeniería industrial; Managerial epidemiology; OR scheduling; Operating room management; Operations research; Overlapping surgeries; Productividad quirúrgica; Programación del quirófano; Solapamiento de cirugías; Surgical productivity; Tiempo controlado por la anestesia; Tiempo de rotación; Turnover time.