An analysis of emergency surgery activity at the royal inland Hospital, Kamloops, BC, Canada February 2012.

1. Emergency
OR usage
FEBRUARY 2012
PERI-OPERATIVE COMMITTEE

2. Emergency OR Usage
 “Without data you’re just another person with an
opinion”
 W. Edwards Deming

3. Emergency OR Usage
 Terms
 Utilization: (u’til*i*za’tion)
 The act of making some area more profitable or
productive or useful.
 Usage: (us*age)
 The act, manner, or amount of using.

4. Emergency OR Usage
 What to know:
 Data collected by IHA
 Aggregated in ExcelR
database
 Some important information difficult to extract
 Been done before (February 2007)

5. Emergency OR Usage
 ER OR time used = 23,270 min
 388 hours
 Total time available (assuming one OR)
 696 hours
 Usage (total) of about 56%
 Usage after midnight = 6%
 Usage daylight = 69.8%

6. Emergency OR usage
Cases by emergency classification
 237 cases
 Class 1 33
 Class 2 66
 Class 3 129

7. Emergency OR usage
 Service by # of cases / by time (hrs.):
 ENT 1 <1
 Dental 3 1.5
 Plastics 9 14
 Urology 11 10
 Vascular 14 21
 Neurosurgery 23 74
 Gynecology 40 27
 General Surg. 50 74
 Ortho. 86 158 = (41%)
(6.5%)

8. Emergency OR usage
Time
(hours)

9. Emergency OR usage
 Case range (in time)
Shortest case 18 min
Longest case 852 min
Lets see?…………that’s 14 hours!

10. Emergency OR usage
(Minutes per case / service)
Time
(min)

11. Emergency OR usage
(night owls)
 Cases after midnight = 16 (6%)
Gynecology
(1.16%)
(18%)

12. Emergency OR usage
(night owls)
 Time after midnight (minutes) =
1244
 6 % of total ER OR time
Time
(hours)
Gyne
This is the period of lowest usage
(6%)
(45%)
(0.06%)

13. Emergency OR Usage
 Things to consider:
 On line ER OR booking system
 Group reference to internet based data
 Real time access
 Less activity at OR desk
 Better statistical control
 Accountability, transparency, stewardship, outlier & cluster detection,
research database, rapid trend analysis

14. Emergency OR Usage
 Things to consider:
 Rules?
 Re-classification (class 1 to class 3)
 Self bumping
 Advocacy
 Week end vs Mid-week case clusters
 Cases per unit of call