In a recently published study, decision tables allowed OR managers at one hospital to schedule procedures more accurately, according to the study’s authors.
Using variables such as patient age and American Society of Anesthesiologists (ASA) physical status can help to better predict turnaround times, and this information can be used for scheduling, the authors wrote. Examples include overlapping induction rooms, to optimize allocating patients to several ORs, which reduces overutilized OR time. They said this information can improve the logistics of listing priorities for transporting patients with advanced age/high ASA physical status to the OR.
The authors wrote that turnaround times are particularly difficult to estimate when dealing with elderly, high-risk patients. The role that patient age and ASA physical status plays in OR management decisions hasn’t been clear, they said.
“We hypothesized that evaluating patient age and ASA physical status in the right model would improve accuracy of turnaround time estimates and, thus, would have decisive implications for OR management,” the authors wrote.
The authors examined 13,632 OR procedures and modeled turnaround times with respect to variables including surgical list, ASA status, length of the procedure, and length of the preceeding procedure. They developed decision tables for OR management that consisted of 50th and 95th percentiles of estimates of turnaround time that were depending on age and ASA status. “In addition, we applied linear and generalized linear multivariate models to predict turnaround times,” they wrote. “The forecasting power of the models was assessed in view of single cases but also in view of critical managerial key figures (50th and 95th percentile turnaround times).”
Using the best models, they achieved an increase in predictive accuracy of 7.7% for all lists, relative to medians of turnaround times that were independent of age/ASA status.
“We constructed a management decision table to estimate age/ASA-dependent turnaround time for OR scheduling at our hospital,” the authors wrote. The study is in the April issue of Anesthesia & Analgesia. The abstract can be accessed by going to http://bit.ly/26hfXnq.