In a hospital setting, the operating room (OR) is one of the most critical areas for patient care, resource utilization, and financial performance. Measuring key performance indicators (KPIs) for ORs is crucial for hospitals to ensure they provide high-quality care, operate efficiently, and achieve financial success. In this article, we will discuss the top 5 Operating Room KPIs to measure for operating rooms in a hospital, including their calculation, importance, and insights they can provide. By understanding these KPIs, hospitals can optimize their OR operations, improve patient outcomes, and achieve greater success.
1. Operating Room Utilization Rate
The operating room utilization rate is the percentage of time that the operating room is in use for a specific period, usually a day or a week. To calculate this KPI, divide the total time that the operating room was in use by the total available time.
Here’s an example of OR utilization calculation for a hospital that has 8 ORs that operate from 8 am to 5 pm:
Assuming that each OR operates for 9 hours a day (8 am to 5 pm), the total available OR hours per day is:
Total OR Hours = Number of ORs x Hours per OR Total OR Hours = 8 ORs x 9 hours
Total OR Hours = 72 hours
Let’s assume that during a given day, the ORs were in use for a total of 50 hours. The OR utilization rate can be calculated as follows:
OR Utilization Rate = (Total Hours Used by ORs / Total Available OR Hours) x 100%
OR Utilization Rate = (50 hours / 72 hours) x 100% OR Utilization Rate = 69.4%
In this example, the OR utilization rate for the hospital on that day was 69.4%. This means that the hospital is effectively using about 70% of its available OR time. By monitoring OR utilization over time, the hospital can identify opportunities to optimize scheduling, reduce wait times, and improve efficiency.
Note: To accurately measure OR utilization, exclude non-patient time such as OR changeover activities (cleaning, set-up time, etc.). Including these times in OR utilization calculations will lead to inflated numbers and provide misleading information to management.
Why it’s important: The operating room utilization rate is a crucial KPI because it measures the efficiency of the operating room. Hospitals want to maximize the utilization rate to ensure they are making the most of their resources. A low utilization rate can indicate that the hospital is not efficiently scheduling surgeries or that there are not enough patients to fill the available time slots. Whereas a high utilization rate indicates that the hospital is making the most of its operating room resources and that surgeries are being scheduled efficiently.
2. Room Turnover Time
The turnover time is the amount of time it takes to prepare the operating room for the next surgery after the completion of the previous surgery. To calculate this KPI, start the timer when the previous Patient is OUT and stop it when the next Patient is IN.
Let’s assume that during a given day, a hospital performed 5 surgeries in one of its ORs. The total time the OR was in use for these surgeries was 8 hours. The total time taken between surgeries to prepare the OR for the next case was 2 hours.
To calculate the turnover time for this OR, we can use the following formula:
Turnover Time = (Total Time Taken for Turnover / Number of Surgeries)
= (2 hours / 5 surgeries)
= 0.4 hours per surgery or 24 minutes per surgery
In this example, the turnover time for this OR was 24 minutes per surgery. By monitoring turnover time over time, the hospital can identify opportunities to streamline processes, reduce wait times, and improve efficiency. A shorter turnover time allows the OR to be utilized more effectively, which can increase patient throughput and reduce patient wait times.
Why it’s important: Turnover time is an essential KPI because it measures the efficiency of the operating room staff. A quick turnover time means that the staff is working efficiently, and the operating room is being utilized more effectively. A slow turnover time can cause delays in scheduling surgeries and impact patient satisfaction.
Learn how you can use the SMED – Lean Technique to optimize the Room Changeover
3. Case Cancellation Rate
The case cancellation rate measures the percentage of scheduled surgeries that are canceled for various reasons, such as patient no-shows, surgeon unavailability, or equipment malfunctions. To calculate this KPI, divide the number of canceled surgeries by the total number of scheduled surgeries.
Let’s assume that during a given month, a hospital had a total of 100 scheduled surgeries in one of its ORs. Of these, 80 surgeries were performed as scheduled, while 20 surgeries were canceled.
To calculate the case cancellation rate for this OR, we can use the following formula:
Case Cancellation Rate = (Number of Cancelled Surgeries / Total Number of Scheduled Surgeries) x 100%
= (20 surgeries / 100 surgeries) x 100%
= 20%
In this example, the case cancellation rate for this OR was 20%. A high case cancellation rate can indicate issues with patient preparation, staff scheduling, or equipment availability, among other factors. By monitoring case cancellation rates over time and identifying the reasons for cancellations, the hospital can take steps to improve patient care and reduce costs associated with canceled surgeries, such as lost revenue and increased staffing costs.
Why it’s important: The case cancellation rate is a crucial KPI because it measures the efficiency of the scheduling process. A high cancellation rate can cause significant disruptions in the operating room schedule and lead to inefficient use of resources.
4. First Case On-Time Start Rate
The on-time start rate for the first case in an operating room is one of the most critical key performance indicators (KPI) utilized to gauge the efficiency of surgical scheduling practices and the effectiveness of the OR staff. This KPI measures the percentage of first cases that start on time, without any deviation from the planned start time.
To calculate this KPI, divide the number of surgeries that start on time by the total number of scheduled surgeries.
Let’s assume that during a given week, a hospital had a total of 10 scheduled surgeries in one of its ORs. Of these, the first surgery of the day was scheduled to start at 8:00am. The actual start times for each surgery during the week are as follows:
- Surgery 1: 8:02am
- Surgery 2: 7:58am
- Surgery 3: 8:10am
- Surgery 4: 7:55am
- Surgery 5: 8:05am
- Surgery 6: 8:03am
- Surgery 7: 8:01am
- Surgery 8: 7:59am
- Surgery 9: 8:07am
- Surgery 10: 7:56am
To calculate the first case on-time starts for this OR, we need to count the number of surgeries that started on time. In this example, only 4 surgeries (surgery 2, 4, and 8) started on time, while the other 7 surgeries started later than 5 minutes after the scheduled start time.
First Case On Time Starts = (Number of Surgeries That Started on Time / Total Number of Surgeries) x 100%
= (3 surgeries / 10 surgeries) x 100%
= 30%
In this example, the first case on-time starts rate for this OR was 30%.
Why it’s important: A delay in the first case often has a domino effect on the rest of the scheduled cases, causing delays in subsequent procedures and compounding the problem. This not only impacts the patient experience but can also lead to surgeon frustration, nurse fatigue, and overall staff dissatisfaction. Poor start time performance can then result in longer days, reduced efficiency, decreased patient throughput, and increased costs.
By monitoring the first case on-time starts over time, the hospital can identify opportunities to improve scheduling and reduce delays, which can improve patient satisfaction and reduce staffing costs associated with overtime and late shifts.
A high on-time start rate is a strong indicator of adequate and effective resource utilization, good coordination, and overall efficiency in healthcare settings. It signifies that resources are being utilized optimally, workflows are well-coordinated, and operations are running smoothly.
5. Surgical Site Infection (SSI) Rate
The Surgical Site Infection (SSI) rate measures the percentage of surgeries that result in a surgical site infection. To calculate this KPI, divide the number of patients who develop an SSI after surgery by the total number of surgeries performed.
Here’s an example of calculating the surgical site infection rate for an OR:
Let’s assume that during a given month, a hospital had a total of 100 surgeries in one of its ORs. Of these, 3 patients developed surgical site infections (SSIs) within 30 days of the surgery.
To calculate the surgical site infection rate for this OR, we can use the following formula:
SSI Rate = (Number of SSIs / Number of Surgeries) x 100%
= (3 SSIs / 100 surgeries) x 100%
= 3%
In this example, the surgical site infection rate for this OR was 3%.
Why it’s important: The SSI rate is a critical KPI because it measures the quality of care provided by the hospital and the effectiveness of infection prevention measures.
A high SSI rate can be indicative of issues with infection control practices, surgical technique, or patient health status, among other factors. By monitoring SSI rates over time and identifying the reasons for infections, the hospital can take steps to improve patient safety and reduce the risk of complications, such as extended hospital stays and readmissions.
Additional Resource
Operating Room Performance Optimization Metrics: a Systematic Review