An Operating Room Scheduling Strategy to Maximize the Use of Operating Room Block Time

TLDR

Determining the appropriate amount of block time to allocate to surgeons and selecting the days on which to schedule elective cases can maximize operating room use, requiring specification of the scheduling method and the average patient wait time. The authors employed a computer simulation using on‑line bin‑packing algorithms, case durations, patient wait times, daily block hours, and weekly block counts to model OR scheduling. The study found that OR utilization rises with longer patient wait times and can be maximized by allocating block time according to expected elective hours, scheduling patients on the first available date within four weeks when block time is available, and otherwise using overflow time outside the block. Anesth Analg 1999;89:7‑20.

Abstract

Determining the appropriate amount of block time to allocate to surgeons and selecting the days on which to schedule elective cases can maximize operating room (OR) use.We used computer simulation to model OR scheduling. Inputs in the computer model included different methods to determine when a patient will have surgery (on-line bin-packing algorithms), case durations, lengths of time patients wait for surgery (2 wk is the median longest length of time that the outpatients [n = 367] surveyed considered acceptable), hours of block time each day, and number of blocks each week. For block time to be allocated to maximize OR utilization, two parameters must be specified: the method used to decide on what day a patient will have surgery and the average length of time patients wait to have surgery. OR utilization depends greatly on, and increases as, the average length of time patients wait for surgery increases. Implications: Operating room utilization can be maximized by allocating block time for the elective cases based on expected total hours of elective cases, scheduling patients into the first available date provided open block time is available within 4 wk, and otherwise scheduling patients in "overflow" time outside of the block time. (Anesth Analg 1999;89:7-20)