The impact of a teaching staff availability on educational process and OR efficiency in academic hospital

Background: The hospital's survival is dependent upon its ability to generate revenue. Operating room (OR) plays a vital role in a hospital's financial health by producing over 40% of its revenue. However, OR efficiency and productivity with their potential to increase returns can vary significantly between academic and private practice settings. The academic OR often lacks the managerial flexibility of private practices, limiting opportunity and maneuverability for initiatives. When the relative rigidity of academic practice is combined with the inherent time requirements and delays associated with the graduate medical education process, the task of improving OR efficiency and productivity in academic institutions becomes challenging. The aim of the study is to evaluate a teaching staff routine of intraoperative availability as a factor of influence on OR efficiency and productivity. Methods: In this prospective observational study, the authors analyzed a breakdown of the perioperative timeline of 100 general surgical cases performed at a tertiary academic medical center in Bronx, New York looking for critical factors affecting both educational contact time and OR efficiency. Results: The analysis revealed that the presence of the attending surgeon and anesthesiologist in the OR prior to the induction of anesthesia and at the time of wound closure increases educational contact time for the respective trainees and decreases non-operative time by approximately 20%. The immediate availability of teaching faculty at these two critical timepoints effectively decreases the overall case duration while increasing teaching contact time but shown to have minimal efficacy to prevent delays or improve conventional turn-over time. Conclusion: The reduced duration of the surgical procedure directly improves OR efficiency and through the potential reduction in overtime costs, it could also be a way to enhance a healthcare institution's financial bottom line.