Abstract: PD58-04
Sources of Funding: None.

Introduction

Surgical quality improvement literature has historically focused on strategies in cost reduction, outcome improvement, and increasing operating room (OR) efficiency. To this point, a vast majority of available literature on OR turnover has focused on institutional factors: role of the surgeon, lean-thinking practices, and team perception of turnover. However, a paucity of research exists on patient-specific factors that may ultimately affect OR duration and turnover. Our objective was to determine the role of patient characteristics on urology OR turnover in both a hospital and ambulatory setting.

Methods

Patients undergoing urology procedures at our institution have routine prospective data collection, including preoperative ASA classification, as well as various time landmarks before, during, and between procedures (time patient enters the OR, time of intubation, etc). Retrospective collection of OR start and end times from an OR scheduling software was conducted. Emergency cases were excluded. Analysis of variance with effects of hospital vs. ambulatory location and ASA class (I-IV) was performed on logarithmically transformed times (to correct skew), followed by Tukeys test for multiple comparisons.

Results

A total of 1766 patients undergoing 1788 urology procedures over a 9 month period (January-September 2016) were stratified by ASA class I-IV. Both ASA class and location significantly affected time from OR start to procedure start, and time from procedure end to OR end; these times increased as ASA class increased. All OR times were significantly less in the ambulatory setting for any given ASA.

Conclusions

Though patient characteristics have long been known to effect intra-operative duration, prior literature has not properly determined the role of patient factors in OR turnover times. Our data demonstrate that turnover times were shorter in our ambulatory setting and that, as ASA class increases, OR start and end times are prolonged. Future quality improvement studies should focus on patient-specific factors that may affect OR efficiency.

Funding

None.