Surgeon profiling: a key to optimum operating room use.

HYPOTHESIS A high-efficiency Pod, composed of 3 parallel-processing operating rooms (ORs) and a dedicated 3-bed miniature postanesthesia care unit, can be filled with surgeons capable of converting time saved from parallel processing into incremental volume. DESIGN Statistical and mathematical modeling. SETTING Academic medical center with 52 serial-processing ORs, 1 parallel-processing OR, and a congested postanesthesia care unit. PARTICIPANTS Elective surgical cases (N = 58 356) performed by a single surgical service without a preoperative intensive care unit bed request from April 1, 2004, through March 31, 2006. INTERVENTIONS Results from our parallel-processing OR (n = 1729) were extrapolated to all other cases (n = 56 627) to estimate the duration of key process time intervals as if they were performed using parallel processing. Cases that could yield incremental throughput using parallel processing were labeled "good." Total good case hours per week were then aggregated for each surgeon. Main Outcomes Measures Surgeons with 4.5 hours per week or more of good case time had a "profile" suitable for a 9-hour block in The Pod every 2 weeks. RESULTS Of the 352 profiled surgeons, 30 had 4.5 hours per week or more of good case time, more than filling the 15 blocks per week. CONCLUSIONS The high-efficiency OR Pod can fill each of its 3 ORs with case/surgeon combinations that should yield additional throughput. Surgeon profiles based on stringent efficiency targets maximize the throughput potential of The Pod's active ORs and more than compensate for the OR turned miniature postanesthesia care unit.