Operating Room Utilization: A Retrospective Analysis of Perioperative Delays

Objective: Avoiding surgical delay in the operating room (OR) is essential to provide timely, safe, and cost-effective care. The objective of this study was to identify the causes of OR delays and assess trends related to surgical specialties or approaches. Materials and Methods: This retrospective study included all elective gynecology (Gyn), general surgery (GS), and urology (Uro) surgeries performed during a 12-month period. Operative case details, surgical times, and reasons for delays were retrieved from a perioperative database. Representative specialty-specific procedures (hysterectomy, colectomy, nephrectomy) were chosen and compared separately to assess trends in delays. Results: A total of 4206 surgeries were completed during the study period; of which 1447 (34%) were Gyn, 2226 (52%) GS, and 533 (12%) Uro. Delays occurred in 1010 Gyn (70%), 1304 GS (59%), and 225 Uro cases (48%). The most-common reason for delay was case-related-delays in case due to delays in prior cases-(n = 1171 [28%]), followed by patient-related delays (n = 458 [11%]), then delays in patient preparedness (n = 340 [8%]). These rates of delay frequency were similar across representative specialty-specific procedures. Delays were more frequent when comparing laparoscopic to open colectomy (38/51, 75% versus 24/25, 96%; p = 0.02), whereas there was no significant difference in delays between laparoscopic and open hysterectomy (162/198, 82% versus 50/68, 74%; p = 0.07) or nephrectomy (4/7, 57% versus 35/76, 46%; p = 0.70). Conclusions: This study suggests that among specialties and cases, the most-common cause of delays was case-related. These findings provide a platform from which to introduce quality-improvement initiatives.