Study flags surgeon workload as key to operating room scheduling gaps

Surgeon schedules may be a larger lever for hospital efficiency than operating room schedules alone, according to University of Massachusetts Amherst researchers. Their study of nearly 86,500 surgeries at Baystate Medical Center found factors linked to longer pauses between a surgeon’s cases, a source of lost time that can affect costs, staffing strain and care delivery.

The work, published in the Journal of the American Medical Informatics Association, comes as surgeons are expected to become harder to find. The Association of American Medical Colleges projected in a 2024 report that the United States could be short 10,000 to 19,900 surgeons by 2036.

Muge Capan, an assistant professor in UMass Amherst’s Riccio College of Engineering and an author of the paper, said surgeon time is one of the costliest parts of an operation. She told UMass Amherst that hospitals need to avoid both idle time and excessive workload because surgeons are people performing skilled, high-risk work.

Looking at time between cases

Hospitals commonly schedule surgeries in blocks, according to the UMass Amherst report. Capan said that approach works poorly for surgery because procedures and surrounding tasks can vary widely, including room cleaning, equipment readiness and whether a surgeon is prepared for the next case.

The research team focused on what happens after one case ends and before the same surgeon begins the next one. Jonathan Akhagbosu, the paper’s first author and a UMass Amherst industrial engineering doctoral candidate, said much prior work has examined operating room turnover, while this study examined the schedule from the surgeon’s perspective.

The team called that interval “gap time.” Using machine learning, the researchers analyzed three years of electronic medical record data from Baystate Medical Center in Springfield, Massachusetts, to identify surgical characteristics that could predict those gaps, according to UMass Amherst.

Emergencies and case demand stood out

The study found several factors associated with longer gaps. According to UMass Amherst, they included whether the previous or next case was an emergency, whether the prior case involved the thorax, whether the next operation involved the heart, and whether a procedure placed high demand on the surgeon.

To measure that demand, the researchers built a metric they called surgical case demand, according to the university. The study grouped cases into three levels: shorter scheduled procedures with lower-severity illness, more demanding operations such as mastectomy or knee replacement, and the most taxing cases, including severe off-hours emergencies such as brain, abdominal or spine procedures.

The researchers also found that ophthalmology and orthopedic surgeries were linked with shorter gaps, according to UMass Amherst.

Potential use in scheduling

Capan said the findings could help hospitals identify “collectible time,” meaning a gap long enough to be used for another procedure. If a delay can be predicted, she said, schedulers may be able to decide whether another case can fit into that period.

The study does not present a finished hospital scheduling system. It identifies variables that may help predict unused time in a surgeon’s day and shows how engineering methods can be applied to hospital operations, according to UMass Amherst.

Capan said industrial engineering aims to understand and reduce variation, and that those methods can be used in complex health systems. Akhagbosu said the broader goal is to reduce waste and improve efficiency in care delivery, according to the university.

This story draws on original reporting from Medical Xpress.