Aim. To perform a thorough and step-by-step assessment of operating room (OR) time utilization, with a view to assess the efficacy of our practice and to identify areas of further improvement. Materials and Methods. We retrospectively analyzed the most ordinary general surgery procedures, in terms of five intervals of OR time utilization: anaesthesia induction, surgery preparation, duration of operation, recovery from anaesthesia, and transfer to postanaesthesia care unit (PACU) or intensive care unit (ICU). According to their surgical impact, the procedures were defined as minor, moderate, and major. Results. A total of 548 operations were analyzed. The mean (SD) time in minutes for anaesthesia induction was 19 (9), for surgery preparation 13 (8), for surgery 115 (64), for recovery from anaesthesia 12 (8), and for transfer to PACU/ICU 12 (9). The time spent in each step presented an ascending escalation pattern proportional to the surgical impact , which was less pronounced in the transfer to PACU/ICU . Conclusions. Albeit, our study was conducted in a teaching hospital, the recorded time estimates ranged within acceptable limits. Efficient OR time usage and outliers elimination could be accomplished by a better organized transfer personnel service, greater availability of anaesthesia providers, and interdisciplinary collaboration. 1. Introduction Operating theatres’ cost constitutes a huge investment of healthcare resources, approximating one-third of total hospital budget [1, 2]. Thus, there is an increasing interest in providing an “efficient” anaesthetic and surgical service [3], to make operations the largest potential source of income [1, 2]. However, case cancellations on the day of surgery, due to suboptimal utilization of theatre time [4–7], is a well-recognized problem in hospitals, ranging from 10% to 40% across different health care systems worldwide, 60% of which could potentially be avoided [8–10]. Delays and consequent cancellations of surgical procedures are arguably an issue of health care quality [8] as well as a major cause of waste of health resources [2, 10]. As a consequence, they prolong the duration of hospitalization causing anxiety, frustration, anger, emotional involvement [11], and inconvenience to patients and their families [12], quite apart from increasing the cost in terms of working days lost and disruption to daily life. The most common causes of cancellation are the patient being unfit for surgery and suboptimal utilization of theatre time [6, 9], with the latter leading to case delays. Several studies have shown
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