Case Study: Analyzing Operating Room Utilization Using Statistical Process Control $($SPC$)$

Objective: Use SPC method we have learned in this class to analyze the utilization of Operating Rooms $($OR$)$ and identify any service processes that may need improvement to improve the service quality and optimize operating room utilization by identifying workflow delays, inaccurate booking times, and cancellations.

Background information: Operating room utilization is critical in healthcare organizations. Inefficiencies in the OR can cost thousands of dollars per year, and can also impact patient care and satisfaction. By applying SPC methods, we can monitor and improve OR utilization.

Dataset: $"2022\_$Q$1\_$OR$\_$Utilization.xlsx$"$ containing details about surgical encounters.

Dataset Description:

Column name Description

Date The date of the surgery. $($Date$)$

OR Suite The operating room # where the surgery will take place. $($String$)$

Service The surgical specialty. $($String$)$

CPT Code The code for the surgical procedure. $($String$)$

CPT Description A description of the surgical procedure. $($String$)$

Booked Time $($min$)$ The amount of time that was booked for the surgery. $($Integer$)$

OR Schedule The time that the surgery was scheduled to start. $($Time$)$

Wheels In The time that the patient arrived in the operating room. $($Time$)$

Start Time The time that the surgery actually started. $($Time$)$

End Time The time that the surgery actually ended. $($Time$)$

Wheels Out The time that the patient left the operating room. $($Time$)$

Requirement and tasks:

Tools: Excel, Python, R$,$ or any statistical software capable of SPC calculating and charting.

Tasks:

$1)$ Data Exploration:

Review the dataset to understand the types of data collected and the potential metrics for analysis.

Identify at least one metrics of interest related to service quality or operation efficiency that you would like to analyze using SPC $($e$.$g$.,$ surgery duration, delays, utilization rates, etc.$).$

$2)$ Initial Data Analysis:

Perform exploratory data analysis to understand the chosen metric or aspect.

Calculate the necessary parameters for each chosen metric. For instance:

$$ Setup and Teardown Time: Time taken before and after the surgery $($difference between $$Wheels In$$ and $$Start Time$,$End Time$$ and $$Wheels Out$).$

$$ Room Turnover: Time between one surgery ending and the next beginning in the same OR$.$

$$ Booked vs$.$ Actually Surgery Time: Compare the booked time with the actual duration from $$Start Time$$ to $$End Time$.$

$$ Turnaround Time: Total time from $$Wheels In$$ of one surgery to $$Wheels In$$ of the next.

$$ Start Delays: Difference between the scheduled start time $($OR Schedule$)$ and actual start time $($Start Time$).$

Calculate relevant statistics $($mean$,$ median, standard deviation, etc.$).$

$3)$ Create SPC Charts:

Select appropriate subgroups for establishing the control chart and that for evaluation of service quality or operation efficiency.

Create appropriate SPC charts $($e$.$g$.,$ X$-$chart, R$-$chart, P$-$chart, I$-$MR chart$)$ for the chosen focus area.

Identify any out$-$of$-$control points and investigate potential causes.

$4)$ Analysis on Specific Aspects $($Optional$)$:

Conduct additional analyses like time series analysis for trends over the quarter, or compare weekdays vs weekends.

Analyze the impact of different OR Suites on surgery times or delays.

Compare and Contrast Different Services or CPT Codes: If focusing on service types or CPT codes, compare the performance and variability across different categories.

$5)$ Report Findings:

Summarize the findings from the control charts.

Identify any trends, patterns, or areas of concern.

Based on the findings, suggest improvements in service quality, OR scheduling or time management.

Discuss any limitations of the analysis and alternative approaches that could be considered.

Potential Analysis Directions:

$$ Efficiency Metrics: Examine setup times, teardown times, turnover times, and case start delays to identify inefficiencies.

$$ Accuracy of Scheduling: Compare booked versus actual surgery times to evaluate the scheduling system's performance.

$$ Service$-$Specific Analysis: Assess if certain services demonstrate higher proportions of delays or overruns.

$$ Operational Variability: Investigate variability in efficiency metrics across different days, times.

Deliverables $($after class$)$:

A report with analysis, charts, and findings.

Recommendations for service quality or OR utilization improvement.