Delays in the operating room: signs of an imperfect system.

TLDR

Operating‑room delays reduce efficiency and negatively affect the working environment. The study prospectively analyzed perioperative system delays recorded by a neurosurgeon across 1,531 elective cases from 2000 to 2009. The authors examined the prevalence, causes, and impact of delays in those cases, documenting all errors prospectively. Delays were the most frequent error (33.6%) and occurred in more than half of cases, mainly due to equipment failure, with first‑case and cranial procedures having more delays and an initial delay predicting subsequent ones, highlighting their impact on patient flow and resource utilization.

Abstract

Delays in the operating room have a negative effect on its efficiency and the working environment. In this prospective study, we analyzed data on perioperative system delays.One neurosurgeon prospectively recorded all errors, including perioperative delays, for consecutive patients undergoing elective procedures from May 2000 to February 2009. We analyzed the prevalence, causes and impact of perioperative system delays that occurred in one neurosurgeon's practice.A total of 1531 elective surgical cases were performed during the study period. Delays were the most common type of error (33.6%), and more than half (51.4%) of all cases had at least 1 delay. The most common cause of delay was equipment failure. The first cases of the day and cranial cases had more delays than subsequent cases and spinal cases, respectively. A delay in starting the first case was associated with subsequent delays.Delays frequently occur in the operating room and have a major effect on patient flow and resource utilization. Thorough documentation of perioperative delays provides a basis for the development of solutions for improving operating room efficiency and illustrates the principles underlying the causes of operating room delays across surgical disciplines.