The cost and profits of surgical inefficiency: An alignment of financial and patient interests
Lisa has been waiting for her surgery to start since arriving at the hospital at 11am this morning. Her scheduled surgery time of 1pm is long gone now at 3pm. While her husband and the nurses reassure her, she feels frustrated and increasingly anxious as the hours advance. Finally, she is taken to the operating room, but the surgical staff is now different from the one she met hours ago. Only the surgeon remains the same.
This scenario is increasingly common in surgery. Surgical inefficiencies manifest as delays, cancellations, and impact safety and outcomes. What Lisa does not know is that the delay has shifted her case to evening coverage, meaning that the surgical staff is also on-call and may not regularly complete the kind of surgery she is having. Her risk of experiencing a complication has increased simply due to the case delay (Cortegiani, Yang). Identifying and resolving inefficiency in the operating room directly impacts patient care.
The costs of surgical inefficiency add up quickly. An operating room only earns money when it is actively being used for surgery. It is important to note that there is significant variability in profitability based on factors including surgical setting, type of surgery, case cost, and payor. The profitability for outpatient elective surgery ranges $40-130 per minute. For every hour an OR sits idle, it loses $2400-7800 in potential revenue.
The profitability of outpatient elective surgery ranges $40-130 per minute.
For every hour an OR sits idle, it loses $2400-7800 in potential revenue.
The profit data is calculated using data from the Nationwide Ambulatory Surgery Sample (NASS) maintained by the Agency for Healthcare Research and Quality for 2016-2017 for the top 10 common ambulatory surgery case types in 2016 and the reported average case times for these surgeries from National Surgical Quality Improvement Program (NSQIP) and published data. The tables in figures 1 and 2 demonstrate this data.
Service to patients does not always align with the financial interests of a healthcare organization. Given the potential profit of $2400-7800 per operating room hour, improving surgical efficiency represents one such opportunity in which patient outcomes overlap with business interests. In Lisa’s shoes, we all share an interest in our surgery starting on time with optimal staffing and tools to avoid frustration and complications.
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