- •We evaluated mean tardiness of to-follow surgeons in operating rooms following surgeons of different specialties.
- •The mean tardiness was no greater when 2 specialties were involved (mean 0.1 min; P = 0.93).
- •Surgeons with afternoon starts can be assured that following a surgeon of another specialty generally does not increase waiting time.
Switching from one specialty to another increases mean turnover times (i.e., interval between the exit and entrance of consecutive patients in an operating room [OR]). We estimate the effect on the mean tardiness of to-follow surgeons from following another surgeon of a different versus same specialty. Tardiness of a case’s start time refers to the number of minutes the patient enters the OR later than scheduled; tardiness is 0 min if the patient enters early. Tardiness cause surgeon waiting. There are multiple causes of tardiness, but, most often, the preceding case(s) took longer than estimated.
10-year historical cohort study with all surgical cases performed during regular workdays.
Large teaching hospital.
Estimated OR end times were calculated using a Bayesian method. Because tardiness is influenced by the estimated case start time (i.e., later starting cases have greater tardiness), tardiness values were adjusted to a 12 noon start time for the 2nd surgeon.
The cases of to-follow surgeons in ORs had mean tardiness of 45.1 (SE 0.6) min. When the to-follow surgeon in the OR was of a different versus the same specialty from the first surgeon, the mean turnover time was 7.3 (0.4) min longer (P < 0.00001). However, the mean tardiness was not significantly affected (0.1 min, 95% confidence interval [CI] −2.7 to 3.0 min; P = 0.93). In comparison, if one or more of the preceding cases in an OR was an add-on case, the increase in mean tardiness was 35 min (95% CI 28 to 43 min; P < 0.00001).
OR managers can assure surgeons with afternoon starts that following a surgeon of a different specialty generally will not increase their waiting time. Case scheduling should focus on reducing over-utilized OR time and thus the hours that anesthesiologists and nurses work late.