Free Standard AU & NZ Shipping For All Book Orders Over $80!
Register      Login
Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE

An assessment of the accuracy of surgical time estimation by orthopaedic theatre staff

Stephen Butler A , Tau Loseli A , David Graham https://orcid.org/0000-0003-3421-822X A B * , Anna Watson A , Mark Kao A , Akshat Saxena C , Brahman Sivakumar B and Adrian Van der Rijt A
+ Author Affiliations
- Author Affiliations

A Department of Orthopaedic Surgery, Wagga Wagga Base Hospital, Docker Street, Wagga Wagga, NSW 2650, Australia.

B Australian Research Collaboration on Hands (ARCH), 4/75 Railway Street, Mudgeeraba, Qld 4213, Australia.

C Department of Orthopaedic Surgery, Liverpool Hospital, Cnr Elizabeth and Goulburn Streets, Liverpool, NSW 2170, Australia.

* Correspondence to: davegraham80@gmail.com

Australian Health Review 46(6) 731-735 https://doi.org/10.1071/AH22046
Submitted: 2 March 2022  Accepted: 26 August 2022   Published: 21 September 2022

© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA.

Abstract

Objective Optimal utilisation of theatre time increases efficiency and reduces the cost of health care. The accuracy of surgical time estimation between different members of the theatre team has not been well documented, and may aid in more efficient utilisation of available theatre time. This study aims to identify the cohort of theatre staff with greatest accuracy in estimating orthopaedic surgical time.

Methods This study was conducted in a prospective fashion using consecutive orthopaedic trauma and elective operative lists over a period of 3 months. Prior to each operating list, a senior member of each of the anaesthetic, orthopaedic and scrub/scout nursing teams predicted the surgical duration for orthopaedic procedures after being provided with information regarding the individual cases. The absolute difference between estimated and actual surgical times was calculated.

Results When expressed as a percentage difference from true surgical time, the orthopaedic team provided the most accurate estimates, with a mean difference of 33.0%. This was followed by nursing staff (40.5%) and anaesthetics (50.9%). Similarly, a higher proportion of estimates by the orthopaedic team were within the limits of 20% underestimation and 10% overestimation (deemed clinically significant).

Conclusions Surgical times for orthopaedic trauma and elective cases are most accurately estimated by the operating team. These estimates should be implemented when planning theatre utilisation, and may benefit computer algorithms for theatre scheduling.

Keywords: efficiency, estimation, health resources, health systems, orthopaedic, resource utilisation, surgical time, theatre time.


References

[1]  Macario A. What does one minute of operating room time cost? J Clin Anaesth 2010; 22 233–236.
What does one minute of operating room time cost?Crossref | GoogleScholarGoogle Scholar |

[2]  Australian Institute of Health and Welfare (AIHW). Australian hospital statistics 2013–14: elective surgery waiting times. Health services series no. 56. Cat. no. HSE 151. Canberra: AIHW; 2014.

[3]  Agency for Clinical Innovation (ACI). National Elective Surgery Targets (NEST) for NSW, Fact sheet, October. 2012. Available at https://aci.health.nsw.gov.au/resources/surgical-services/delivery/predictable-surgery/documents/fact_sheets/NEST-fact-sheet.pdf [accessed 20 April 2015]

[4]  Sorge M. Computerized O.R. scheduling: is it an accurate predictor of surgical time? Can Oper Room Nurs J 2001; 19 7–18.

[5]  Wright IH, Kooperberg C, Bonar BA, Bashein G. Statistical modeling to predict elective surgery time: Comparison with a computer scheduling system and surgeon-provided estimates. Anesthesiology 1996; 85 1235–1245.
Statistical modeling to predict elective surgery time: Comparison with a computer scheduling system and surgeon-provided estimates.Crossref | GoogleScholarGoogle Scholar |

[6]  Roque DR, Robison K, Raker CA, Wharton GG, Frishman GN. The Accuracy of Surgeons’ Provided Estimates for the Duration of Hysterectomies: A Pilot Study. J Minim Invasive Gynecol 2015; 22 57–65.
The Accuracy of Surgeons’ Provided Estimates for the Duration of Hysterectomies: A Pilot Study.Crossref | GoogleScholarGoogle Scholar |

[7]  Delaney CL, Davis N, Tamblyn P. Audit of the utilization of time in an orthopaedic trauma theatre. ANZ J Surg 2010; 80 217–222.
Audit of the utilization of time in an orthopaedic trauma theatre.Crossref | GoogleScholarGoogle Scholar |

[8]  Travis E, Woodhouse S, Tan R, Patel S, Donovan J, Brogan K. Operating theatre time, where does it all go? A prospective observational study. Br Med J 2014; 349 g7182
Operating theatre time, where does it all go? A prospective observational study.Crossref | GoogleScholarGoogle Scholar |

[9]  Goel R, Kanhere H, Trochsler M. The ‘Surgical Time’: a myth or reality? Surgeons’ prediction of operating time and its effect on theatre scheduling. Aust Health Rev 2020; 44 772–777.
The ‘Surgical Time’: a myth or reality? Surgeons’ prediction of operating time and its effect on theatre scheduling.Crossref | GoogleScholarGoogle Scholar |

[10]  Kargar ZS, Khanna S, Sattar A. Using prediction to improve elective surgery scheduling. Australas Med J 2013; 6 287–289.
Using prediction to improve elective surgery scheduling.Crossref | GoogleScholarGoogle Scholar |

[11]  Eijkemans MJC, van Houdenhoven M, Nguyen T, Boersma E, Steyerberg EW, Kazemier G. Predicting the unpredictable: a new prediction model for operating room times using individual characteristics and the surgeon’s estimate. Anesthesiology 2010; 112 41–49.
Predicting the unpredictable: a new prediction model for operating room times using individual characteristics and the surgeon’s estimate.Crossref | GoogleScholarGoogle Scholar |