====== Operating room time ======

It is estimated that 70% of [[hospital revenue]] is generated in the [[operating room]] (OR)
((Li F, Gupta D, Potthoff S. Improving operating room schedules. Health Care Manag Sci. 2016 Sep;19(3):261-78. doi: 10.1007/s10729-015-9318-2. Epub 2015 Feb 17. PMID: 25687390.))

Operating room time includes patient [[stay]], from [[arrival]] to [[exit]].

Although [[cost reduction]] increases for [[implant]]s in surgery when prices are known, this appears to have little or no effect on the overall [[cost]]s of [[care]]. [[Length of stay]] and [[operating room]] time have greater effects on global [[cost]]s. Future efforts to encourage efficient cost savings should focus on practice patterns/pathways for similar conditions rather than limiting the use of certain implants
((Glennie RA, Barry SP, Alant J, Christie S, Oxner WM. Will cost transparency in the operating theatre cause surgeons to change their practice? J Clin Neurosci. 2019 Feb;60:1-6. doi: 10.1016/j.jocn.2018.09.024. Epub 2018 Oct 26. PMID: 30626523.)).

For the [[operating room]] management, the basis is the surgical suite, and evaluation can be divided into duration of [[anesthesia]], [[operative time]], [[operating room time]], and [[operating room preparation time]].

===== Duration of anesthesia =====

The lengthiest stage during a [[procedure]] is [[anesthesia]].

Anesthesia duration is divided into four moments: anesthetic induction, maintenance, awakening, and recovery.

===== Operative time =====

The operative time consists of [[dieresis]], [[hemostasis]], [[exeresis]], and [[suture]].

===== Operating room preparation time =====

[[Operating room preparation time]]




===== Operating room time in public hospitals =====

[[Public hospital]]s provide free [[healthcare]] but suffer from poor [[management]] and misgovernance, negatively impacting service provision. One aspect of this is [[operating room time]] utilization.

Fifty-six percent of [[operating room time]]  was utilized operating. Sources of delay included the delayed arrival of the anesthesia team (4.7%) and the delay in transferring patients to OT (9.7%). Anesthesia intubation and preparation time accounted for 23% of OT utilization and was significantly longer than comparable international studies. [[Extubation time]] accounted for 5.7% of OT utilization

Gross delays relatively simple in nature were identified due to poor management and less than ideal inter-specialty coordination. Most delays were avoidable and can be addressed by proper planning, optimization of patient transfer and resources, and, most importantly, improved communication between surgeons, anesthetists, and ward staff. This can ensure optimal use of theater time and benefit all specialties, including ancillary staff, and, most importantly, the patient
((Ashraf M, Kamboh UA, Raza MA, Khan MI, Sultan KA, Choudhary N, Hussain SS, Ashraf N. Prospective Elective Neurosurgical Theater Utilization Audit in Pakistan: Problems in a Public Tertiary Care Hospital and Proposed Solutions from Lower-Middle-Income Country. Asian J Neurosurg. 2022 Jun 10;17(1):58-67. doi: 10.1055/s-0042-1749110. PMID: 35873839; PMCID: PMC9298559.)).
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