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Performance Management in Operating Rooms


  • Ruchika Goyal
  • Agency : Performance Management, Operating Room, Surgical Services
  • Objective : The study was carried out, to assess the efficiency in the operating rooms. The purpose was to identify service-focused opportunities for efficiency improvement, and to guide continuous improvement activities within operating rooms and anesthesia services.
  • Background : As healthcare organizations look for ways to gain new efficiencies and reduce costs, they are examining surgical services with a critical eye. In many cases, the operating room (OR) was not included in enterprise wide reengineering efforts, thereby limiting the positive impact of those efforts. Healthcare organizations are recognizing that every point along the patient care continuum is interrelated. To truly maximize reengineering efforts, they need to integrate the entire process and information flow within the OR and across the enterprise.
  • Methodology : A descriptive study was carried out and both primary and secondary data was collected. An analysis of capacity utilization was done by calculating the percentage utilization of the operating rooms, percentage of first case start delays and the number of cases cancelled and rescheduled. The scheduling process was studied and reasons for delays in the surgeries were stated.
  • Findings : During the past seven months i.e. from July Ď09 to March Ď10 total 3577 surgeries were carried out. Avg. utilization of OR during the elective hours is approximately 60%. On an average 45% were FCS delays, 5.7% surgeries cancelled and approx. 21% were rescheduled. OR six and seven were underutilized as compared to the others due to inappropriate case mix. The ORís were not differentiated specialty wise leading to discrepancies in case mix and poor predicted time of case length. Forecasting shows that the utilization of ORís would increase from the current utilization of 60% to 70%.
  • Recommendations : A large amount of cost is incurred to run the operating rooms, under runs leads to opportunity cost during the un-utilized hours and lowers the contributing margin. So to streamline the processes and to improve the efficiency in the operating room a balanced scorecard approach was introduced as a performance management tool.  
to assess the efficiency in the operating rooms. The purpose was to identify service-focused opportunities for efficiency improvement