Case delay in the OR morning start in hospitals of different size and academic status : Results from aGerman multicenter study to identify incidence and causes of delayed anesthesia ready time.

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Delays in the start of morning operations cause aloss of expensive OR capacity as well as frustration and potential conflicts among the different professions involved. There are alot of reasons which can lead to delayed anesthesia ready time (ART). This is the first large multicenter study to identify incidence, extent and reasons of delay in ART. First case delays in ART were studied in all regular ORs in 36hospitals of different sizes (smaller community hospitals, larger community hospitals and university hospitals) over aperiod of 2weeks. We analyzed the results comparing the 3hospital types regarding incidence, extent and reasons for delay. Atotal of 3628 first of day cases were included in the study. Incidences of delayed ART (delay >5 min) ranged from 26.5% in university hospitals to 40.8% in larger community hospitals. However, university hospitals had higher incidences than smaller community hospitals of delays greater than 15and 30 min. The main reasons for delays were prolonged induction of anesthesia, patient in-hospital logistics and delayed patient arrival at the hospitals. The highest mean delay of delayed cases was found in university hospitals with 21.7 min ± 14.7 min (SD). Delays in anesthesia ready time have ahigh prevalence in most hospitals, however the reasons for delay are manifold, making interventions to reduce delay complex.