The timing of the operatingroom: a 2019 Italian exsperience

Abstract Background The lack of economic resources for health systems is a public health issue that Europe needs to address in order to guarantee quality and safety of care for patients. Any initiative aimed to reduce waste are welcomed. In this context, the City of Health and Science of Turin (Italy) performed a study aimed to analyse the timing of operating rooms to improve efficacy, efficiency and quality standards in the surgical field. Methods A multidisciplinary working group created in 2019 a checklist aimed to record the operating times of the first intervention of the day in 5 Hospital Departments (including 12 operating rooms). We registered the time between the moment in which the operating room is considered available for the start of activities and the surgical incision (benchmark: within 60 minutes). All the times needed for nursing, anesthetic and surgical activities were collected and evaluated for a descriptive statistical analysis. Results In consideration of a room opening time scheduled for 7:00 and room availability scheduled for 7:30, the goal can be considered achieved if the time of the surgical incision does not exceed 8:30 in the morning. Three out of 5 departments (Ginecology, Orthopaedic and General surgery) reached this aim in more than 80% of interventions, while neurosurgery and thoracic surgery exceeds the time by about 40 minutes. The checklist showed that in many cases is possible to reduce the time between the end of anesthesia and surgical incision. Conclusions To analyse the operating times allows not only to optimize the resources but also to reduce waste of time and waiting lists for surgery in election. We described, in a sample of surgical interventions, when and how is possible to improve the efficiency of the operating room. This experience and the checklist created could be useful not only for us but every European hospital. Key messages The efficiency of operating rooms is related to several factors. Neurosurgery and thoracic surgery needs longer time to prepare patients and start intervention. A checklist aimed to monitor the times of activities in surgical operating rooms can be useful to reduce waste of time and resources in European hospitals.