Luke Martin1, John Langell2. 1. Specialty Care Center of Innovation, George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah; Department of Surgery, School of Medicine, University of Utah Health Sciences Center, Salt Lake City, Utah. Electronic address: luke.martin@hsc.utah.edu. 2. Specialty Care Center of Innovation, George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah; Department of Surgery, School of Medicine, University of Utah Health Sciences Center, Salt Lake City, Utah.
Abstract
BACKGROUND: Operating room (OR) time is expensive. Underutilized OR time negatively impacts efficiency and is an unnecessary cost for hospitals. The purpose of this study was to evaluate the impact of a pre-OR timeout and performance pay incentive on the frequency of on-time, first surgical starts. METHODS: At a single Veterans Affairs Medical Center, we implemented a pre-OR timeout in the form of a safety-briefing checklist and a modest performance pay incentive for on-time starts (>90% compliance) for attending surgeons. Data were collected on all first-start cases beginning before implementation in 2008 and continued through 2015. RESULTS: Each year, an average of 960 first starts occurred across nine surgical divisions. Before implementation of either the timeout or pay incentive, only 15% of cases started on time, and by 2015, greater than 72% were on time (P < 0.001). Over the study period, there were significant improvements in on-time starts (P = 0.01), of delays <15 min (P = 0.01), and of delays 16 to 30 min (P = 0.04). The trends for delays of 31 to 60 min or >60 min were not significant (P = 0.31; P = 0.81). Assuming a loss of 7 min per case for delays <15 min and 20 min per case for delays of 16 to 30 min, the total OR time saved from implementing these measures was 37,556 min. At an estimated cost of $20/min, gross savings from this project were $751,120. CONCLUSIONS: Implementation of a pre-OR timeout and performance pay for on-time starts significantly improves OR utilization and reduces unnecessary costs. Published by Elsevier Inc.
BACKGROUND: Operating room (OR) time is expensive. Underutilized OR time negatively impacts efficiency and is an unnecessary cost for hospitals. The purpose of this study was to evaluate the impact of a pre-OR timeout and performance pay incentive on the frequency of on-time, first surgical starts. METHODS: At a single Veterans Affairs Medical Center, we implemented a pre-OR timeout in the form of a safety-briefing checklist and a modest performance pay incentive for on-time starts (>90% compliance) for attending surgeons. Data were collected on all first-start cases beginning before implementation in 2008 and continued through 2015. RESULTS: Each year, an average of 960 first starts occurred across nine surgical divisions. Before implementation of either the timeout or pay incentive, only 15% of cases started on time, and by 2015, greater than 72% were on time (P < 0.001). Over the study period, there were significant improvements in on-time starts (P = 0.01), of delays <15 min (P = 0.01), and of delays 16 to 30 min (P = 0.04). The trends for delays of 31 to 60 min or >60 min were not significant (P = 0.31; P = 0.81). Assuming a loss of 7 min per case for delays <15 min and 20 min per case for delays of 16 to 30 min, the total OR time saved from implementing these measures was 37,556 min. At an estimated cost of $20/min, gross savings from this project were $751,120. CONCLUSIONS: Implementation of a pre-OR timeout and performance pay for on-time starts significantly improves OR utilization and reduces unnecessary costs. Published by Elsevier Inc.
Authors: Dinesh S Pashankar; Anna M Zhao; Rebecca Bathrick; Cindy Taylor; Heidi Boules; Robert A Cowles; Matthew Grossman Journal: Pediatr Qual Saf Date: 2020-06-24
Authors: Blake Saul; Elise Ketelaar; Amjad Yaish; Michael Wagner; Robert Comrie; Grace D Brannan; Carolina Restini; Michelle Balancio Journal: Spartan Med Res J Date: 2022-09-06