Dexter F, Macario A. When to release allocated operating room time to increase operating room efficiency. Anesth Analg 2004; 98:758-762.

While same-day surgery managers debate the best way to allocate and release OR time to surgeons who need extra time, a recent study in Anesthesia & Analgesia shows it doesn’t matter when you release one surgeon’s time to another surgeon. It is the fact that you allocate OR time correctly and then make adjustments based on scheduled workload that make a difference.

Researchers used real surgery schedules into which they inserted hypothetical cases that exceeded one service’s or one surgeon’s allocated OR time. The effects of the insertions, three to five days before the surgery date and the day preceding the surgery date, on OR efficiency were evaluated.

The study used data from two surgical suites. There were 754 regularly scheduled OR days during the three-year period studied. The schedules included 16,114 elective cases at the ambulatory surgery center participating in the study and 30,775 elective cases at the hospital surgical suite.

The authors took the real surgical schedules from the two surgery programs and evaluated the results when hypothetical cases that ranged in duration from one to three hours in length were added to the schedule at different times. They repeated this process with the hypothetical case scheduled on Thursday prior to the Friday on which surgery would occur.

The authors found that postponing the decision of which service has its OR released for the new case until early the day before the surgery reduces overutilized OR time by less than 15 minutes per OR per day unless the surgical suite typically handles cases of three hours in length.

They noted postponing the decision to release time until the day before the surgeon wants to schedule a case most likely will reduce the satisfaction of the surgeon asking for the time. The delay, however, will increase the satisfaction of the surgeons whose time is being released, they added.