This document outlines key OR dashboard metrics that can be used to monitor performance and identify areas for process improvement. It discusses metrics such as case volume, utilization, operational stats like turnover time and on-time starts, and goals for each metric. Specific examples are provided of hospitals that analyzed their dashboard data and were able to significantly improve processes like decreasing turnover time from 35 to 25 minutes through addressing staffing levels and communication.

1. Top 10 OR
Dashboard Metrics
Pamela Ereckson Fox, MD

2. OR Dashboard Metrics
• Volume
– Case Volume
– Case Minutes
– Case Minutes by Time of the Day
• Utilization
– OR Utilization by Day of Week
– Block Utilization
2

3. OR Dashboard Metrics
• Operational Stats
– Turnover Time
– On Time Starts
– Cancellations
– Add Ons
– Overtime Minutes

4. Case Volume
• Reflects total number of cases over time
• Compares inpatient to outpatient volumes
• Allows you to follow growth as well as seasonal
variation
– The following sample hospital has a decrease
in volume in August which reflects a time
when many surgeons take vacation
• Average number of cases per OR per year in best
practice ORs
– Inpatient 900 cases per OR/year
– Outpatient 1400 cases per OR/year

6. Case Minutes
• Reflects total number of minutes of surgery per
month.
• Also reflects growth as well as seasonal variation
• Comparison between volume and minutes helps in
determining growth patterns
– Increase in volume with a small increase in
minutes usually means a growth in smaller
cases usually outpatient
– Small increase in volume with a larger
increase in minutes usually means a growth
in longer cases usually inpatient

8. Case Minutes by Hour of the Day
• Allows you to look at what percentage of case
minutes are completed in each shift
• Goals
– 90% of minutes completed between 7am-3pm
– 95% of minutes completed by 5pm
• Following sample hospital graph shows a process
improvement project that started in June at 84%
completion by 3pm with increase of completion to
90% over 6 months. Processes addressed were
• Start time
• TOT
• Revision of block schedule
• Staffing levels

10. OR Utilization by Day of the Week
• Reflects total OR utilization on each day of the week
• The goal is to even out the utilization so there is little
variation between the days of the week
• Goal in best practice ORs is 75%-80% total OR
utilization. This allows adequate “flex” in the system
• The following sample hospital revised its block
schedule to allow better utilization of Thursdays and
Fridays

12. Block Utilization
• Block utilization is calculated by surgeon/service
• It is best to use adjusted utilization in order to not
penalize a surgeon for TOT
– Adjusted Utilization= total block minutes
utilized +TOT/ total block minutes available
• Goal is 75% block utilization in order to maintain
block. When decreasing blocks according to
utilization you should decrease by days of the month
not hours of the day
– Example: A surgeon w/ 50% utilization of a
block on Monday would have the block
reduced to either the 1,3,5 Monday of the
month of the 2,4 Monday

13. Block Utilization
13
3 mo
avg
3 mo
avg

14. OR Start Times
• Defined as time patient enters the operating room
• Usually monitored at exact time and within 10
minutes
– Example: 0720 exact time while also
monitoring the 10 minutes later at 0730
• Goal is 90% within 10 minutes
• Sample hospital on next slide reflects a PI project
that improved start time from 65% to 85%. Issues
addressed were
– Communication between team members
– Monitoring of start times
– Communication to surgeons the importance
of on time starts by the OR committee
– Change in Preoperative Patient preparation

16. Average Turnover Time
• Turnover time is calculated as patient out of the
room to next patient in the room
• We usually follow same surgeon turnovers since
there is quite a bit of variability when turning over
between 2 different surgeons or services
• Goals
– Outpatient 10-20 minutes
– Inpatient 30-40 minutes
• Sample hospital slide shows a PI project that begin
in April. Issues addressed included
– Staffing Levels
– Communication between team members
– Preoperative patient workup

17. Average TOT

18. Overtime Staffing Minutes
• Reflects amount of overtime minutes paid to OR
staff
• Sample hospital PI project decreased overtime
minutes significantly over a 4 month period by
addressing
– On time starts
– TOT
– Staffing levels by time of the day
– Block Scheduling
• Gaps in schedule
• Overbooking.
– Example: A surgeon with an 8 hour block routinely
runs 10 hours. The block should be adjusted to 10
hours and staffing levels changed to meet this need

20. Cancellations
• Usually monitor same day cancellations
• Factors that impact cancellations
– Preoperative preparation including
pre-anesthesia testing and patient education
• Sample hospital slide shows a PI project for
preoperative preparation that included a
pre-anesthesia testing clinic, that provided not only
testing but patient education and financial
counceling/insurance verification
• Goals
– <1% for an outpatient setting
– <10% for a major trauma center

22. Add Ons
• Reflects adequate open/urgent time
– Open time is time available to anyone and can
be booked in advance. This accommodates
the non-blocked surgeons
– Urgent time is time available starting 24 hours
before. This accommodates many cases that
need to be done urgently but are not
emergent. Many general surgery and urgent
ortho cases fit into this category
• Goal < 20%