The July Spike in Operating Room Management: Reality or Perception?

Abstract

Background Some research has found increased incidence of medical errors in teaching hospitals at the beginning of the academic year and have termed this the "July Phenomenon." Objective Our primary hypothesis was that the "July Phenomenon" for anesthesiology and surgical residents might manifest itself as operational inefficiency, measured by monthly total operating room (OR) minutes. Secondary measures were monthly elective overutilized minutes (OR workload minus OR allocated time, after 5:30 pm at our institution), 80th percentile number of ORs running at 7:00 pm, and mean last room end time. Methods Data were collected retrospectively from a 525-bed academic tertiary care hospital from January 2010 to September 2014 and were deconstructed to assess for a seasonal component using local regression (Loess). Variable month length was addressed by transforming the monthly totals to average daily minutes and overutilized minutes. Linear regression quantified significance for all primary and secondary analyses. Results In the regressions, monthly average minutes showed no significant difference in July (P = .65) compared to the baseline month of April. There were no significant differences for any month for overutilized minutes or 80th percentile number ORs working at 7:00 pm. Only August was significant (P = .005) for mean last room end time. Conclusions Data from a single institution study did not show a "July Phenomenon" in the number of operating minutes, overutilized minutes, or the number of ORs working late in July.