Elizabeth van Veen-Berkx1, Sylvia G Elkhuizen2, Bart Kuijper3, Geert Kazemier4. 1. Department of Operating Rooms, Erasmus University Medical Center Rotterdam, s-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands. Electronic address: e.berkx@erasmusmc.nl. 2. Department of Health Care Logistics, Institute for Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands. 3. Department of Hospital & Health Care, Logex, Amsterdam, The Netherlands. 4. Department of Surgery, VU University Medical Center Amsterdam, Amsterdam, The Netherlands.
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.
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.
Authors: Katie J Sheehan; Boris Sobolev; Pierre Guy; Jason D Kim; Lisa Kuramoto; Lauren Beaupre; Adrian R Levy; Suzanne N Morin; Jason M Sutherland; Edward J Harvey Journal: BMC Health Serv Res Date: 2020-10-10 Impact factor: 2.655