Closing Emergency Operating Rooms Improves Efficiency

  • Authors:
  • Gerhard Wullink;Mark Houdenhoven;Erwin W. Hans;Jeroen M. Oostrum;Marieke Lans;Geert Kazemier

  • Affiliations:
  • Department of Operating Rooms, Erasmus University Medical Centre, Rotterdam, the Netherlands 3000CA and Department of Intensive Care, Erasmus University Medical Center, Rotterdam, the Netherlands;Department of Operating Rooms, Erasmus University Medical Centre, Rotterdam, the Netherlands 3000CA and Department of Intensive Care, Erasmus University Medical Center, Rotterdam, the Netherlands;School of Business, Public Administration and Technology, University of Twente, Enschede, the Netherlands 7500AE;Department of Operating Rooms, Erasmus University Medical Centre, Rotterdam, the Netherlands 3000CA and Department of Intensive Care, Erasmus University Medical Center, Rotterdam, the Netherlands;School of Business, Public Administration and Technology, University of Twente, Enschede, the Netherlands 7500AE;Department of Operating Rooms, Erasmus University Medical Centre, Rotterdam, the Netherlands 3000CA and Department of Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands

  • Venue:
  • Journal of Medical Systems
  • Year:
  • 2007

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Abstract

Long waiting times for emergency operations increase a patient's risk of postoperative complications and morbidity. Reserving Operating Room (OR) capacity is a common technique to maximize the responsiveness of an OR in case of arrival of an emergency patient. This study determines the best way to reserve OR time for emergency surgery. In this study two approaches of reserving capacity were compared: (1) concentrating all reserved OR capacity in dedicated emergency ORs, and (2) evenly reserving capacity in all elective ORs. By using a discrete event simulation model the real situation was modelled. Main outcome measures were: (1) waiting time, (2) staff overtime, and (3) OR utilisation were evaluated for the two approaches. Results indicated that the policy of reserving capacity for emergency surgery in all elective ORs led to an improvement in waiting times for emergency surgery from 74 (卤4.4) minutes to 8 (卤0.5) min. Working in overtime was reduced by 20%, and overall OR utilisation can increase by around 3%. Emergency patients are operated upon more efficiently on elective Operating Rooms instead of a dedicated Emergency OR. The results of this study led to closing of the Emergency OR in the Erasmus MC (Rotterdam, The Netherlands).