The Role of Patient- and Procedure-Specific Factors on Urology Operating Room Peri-Operative Times

Abstract

IntroductionThough not traditionally examined, the non-operative time a patient spends in the OR is potentially significant. Our objective was to determine the role of patient- and procedure-specific characteristics on non-operative times in urology cases. MethodsAll patients at our tertiary institution had routine pre-operative collection of patient and procedure-specific data. Following IRB approval, we retrospectively reviewed the following time landmarks: the pre-operative OR time (the time from when the patient enters the room until the procedure starts) and the post-operative OR time (the time from the procedure end until the patient exits the room). Study inclusion criteria consisted of ASA I-IV and those cases with complete available data. Emergency cases (ASA score>4) were excluded. Multivariable regression was used to assess influence of patient and procedure variables on pre-operative and post-operative OR time. ResultsA total of 1488 patients undergoing 1786 urology procedures over a 9 month period (January-September 2016) met inclusion criteria. Following multivariable analysis, ASA class and CCI were significantly associated with an increase in pre-operative time. The only variable that had a significant association with both pre-operative and post-operative times was location (hospital vs. ambulatory). Procedure type also had significant effect on peri-operative OR times. ConclusionsOur analysis is a novel approach to assessing OR efficiency by characterizing the non-operative time a patient spends in the OR. Robotic cases have longer non-operative times and increasing patient complexity prolongs pre-operative time in the OR. Better preparation of complex patients pre-operatively will allow better use of constrained OR resources.