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Assessment of the operating room efficiency by the real time of room occupancy.

BACKGROUND
The operating room is the most cost consuming area of hospitals. However, it still suffers from a non-optimized organization.


AIM
To evaluate the performance of our operating rooms by the real room occupancy time (RROT), to identify the main causes of its alteration and to analyze the problem of deprogramming.


METHODS
This is an observational and descriptive study conducted in two operating rooms in Sahloul teaching Hospital during August 2016. For the two studied rooms, a pre-established data sheet was filled during the days of scheduled activity. Collected parameters were  total RROT,  different periods of RROT, room occupancy rate, room overflow rate, incidence and causes of non-compliance with the surgical program and causes of RROT alteration.


RESULTS
  The mean start time of the activity was 41.93 min/day. The mean overflow time was 11.51 min/day. The RROT was 246.56 min/day, corresponding to an average occupancy rate of 68.49%. On average 1.86 acts were performed per room and per morning with a total of 86 interventions. The deprogramming problem was noted in 38 cases. Its main causes were the overshoot of the vacation time offered to surgeons (36.84%), the emergencies (18.42%) and the non-respect of the anesthesia instructions (15.78%).


CONCLUSION
The occupancy rate in our structures is relatively acceptable but should not hide the need to optimize the use of available resources. Corrective actions focusing primarily on delayed start-up and periodic reassessments are essential.