Few studies have examined variability in OR utilization across weekdays. We conducted a retrospective analysis to determine OR utilization differences by day of the week and the source and financial effects of any variability. We extracted 55 months of data from a surgical data repository to calculate OR utilization, late starts, idle times, and delays for each weekday. Declines in OR utilization occurred as the week progressed and were attributed to compounding changes in late start, delay, and idle time. The average weekly cost for each OR associated with unused staffed minutes below a target OR utilization of 85% was $19,383, and the comparable lost weekly revenue was $60,256. Perioperative leaders should identify sources of OR utilization variability when developing strategies that enhance outcomes for patients, minimize costs, and maximize revenue.

Background With the ever-increasing complexity of today\'s healthcare environment, it is evident that there is a higher demand to deliver high-quality, accessible, efficient, and affordable healthcare. At the same time, these changes are accompanied by decreasing rates of reimbursement. This can be attributed to the shift from fee-for-service to value-based payment methods in the industry. The reception of such changes in the appropriate manner is crucial to improvement and the much-demanded reform in our healthcare system. To adapt to this changing landscape, hospitals and healthcare systems must incorporate proper measures to identify extraneous spending, control costs, and streamline patient care. Our goal in this study was to use the time-driven, activity-based costing (TDABC) model to quantify the costs at every step as an inpatient goes through the care process in an interventional radiology department. Methodology After identification and mapping of all the steps involved from interventional radiology (IR) consult placement to patient transport to the postoperative recovery area, time data were collected for each step of the process. One of the steps was then selected for intervention. Our focus was on the time interval between one patient leaving after a completed procedure and the next scheduled patient entering the IR suite (heretofore referred to as idle time). To decrease the idle room time between patients, the interventional radiologists, IR administrations, nurse manager, transportation manager, and charge nurse first met as a group to set a realistic initial goal. Pre-intervention data were collected. Results After the collection of pre-intervention data, the average idle time of the IR suite was found to be 40 minutes. After a multidisciplinary discussion, our goal was to reduce this time to 25 minutes. Post-intervention data found the average time decreased to 24 minutes. Calculation of average costs per unit time for staff, IR room, and equipment yielded an approximate cost of $57 per minute of time in the IR suite. Conclusions Considering the near 40% decrease in suite idle time as well as the cost per minute of material, equipment, and staff (at ~80% capacity), this study proves that the TDABC system is a viable method of targeting bottlenecks in operations and streamlining patient care by reducing costs while optimizing the process patients go through during care continuum.

Idle time at work is a phase of involuntary downtime during which employees experience that they cannot carry out their work tasks. In contrast to breaks, interruptions, procrastination, or withdrawal behavior, employees cannot work because of the absence of work-related tasks. Based on action regulation theory, we develop an integrative conceptual model on the antecedents and consequences of the subjective experience of idle time. We propose that work constraints (i.e., regulation problems) have negative effects on occupational well-being and task performance, and that these effects are mediated by subjective idle time. The strength of these effects is further assumed to be influenced by individuals\' use of proactive (i.e., prevention) and adaptive (i.e., coping) strategies. Results of a supplemental qualitative study, for which we interviewed 20 employees from different occupations, provided preliminary support for the propositions. Finally, we develop theory on how individual, situational, and organizational characteristics may influence the proposed effects on and of idle time. Overall, this conceptual development paper contributes to a better theoretical understanding of idle time at work by extending its definition and applying action regulation theory to this practically important phenomenon.

This research aimed to compare the rumination time estimated by an electronic monitoring system with direct visual observations of the rumination of dairy cows in a grazing-based system. Also, it aimed to estimate the agreement between different time intervals of the direct visual observations. To that end, we have observed twelve lactating cows for 16 h a day for 11 days. Then, we compared the data provided by the HealthyCow24® software with the visual observations to use as reference. After that, we estimated the Pearson\'s correlation coefficients, the linear regression, and the Bland-Altman plot by using the SAS software. Results showed that the rumination data estimated by the HealthyCow24® software and the visual observations were highly correlated (0.81; P < 0.0001). In the Bland-Altman analysis, we observed that the average of the standard deviations between the visual observation and the electronic monitoring system was - 2.14 min during a 2-h period. The upper limit (95%) was 30.61 min/2 h and the lower limit (95%) was - 34.88 min/2 h. Moreover, visual observations at intervals of up to 15 min were correlated with the data estimated by the electronic monitoring system and observed at 5-min intervals. In conclusion, the Allflex SCR electronic monitoring system is efficient in measuring the rumination time of grazing cows. Also, direct visual observations with intervals no longer than 15 min are reliable when used for evaluating the behavior of cows without losing data accuracy.

OBJECTIVE: To describe the development and demonstrate the use of a statistical framework based on statistical quality control (SQC) in order to monitor the performance of operating rooms (ORs).
METHODS: Data related to scheduled surgical operations have been collected from the information system of an existing Greek hospital. The data that contain the anesthesia and operation start and completion times of the operations carried out in the 14 ORs of the hospital are analyzed using control p-charts and hypotheses testing. The results obtained provide crucial information to health-care managers.
METHODS: A large Greek public hospital.
METHODS: Real-world data captured on daily basis from January 2015 to November 2017.
METHODS: The proportion of the idle time of an OR over its total available time is proposed as an OR key performance index. We present two directions of data monitoring and analysis: one that uses control p-charts and a second based on hypotheses testing. The improved Laney\'s p΄-chart and the Laney\'s approach for cross-sectional data are employed in order to overcome overdispersion that affects OR idle time data.
RESULTS: The proposed methodology allows hospital management (i) to monitor the percentage of the idle time of an operating room through time and (ii) to identify the ORs that demonstrate exceptionally high or low percentage of idle time at a given period of time.
CONCLUSIONS: SQC charts are simple, yet powerful tools that may support the hospital management in monitoring OR performance and decision-making. The development of a dedicated management information system that automatically captures the required data and constructs the corresponding control charts would support effectively managerial decision-making.

BACKGROUND: The aim of this study was to evaluate validity evidence using idle time as a performance measure in open surgical skills assessment.
METHODS: This pilot study tested psychomotor planning skills of surgical attendings (n = 6), residents (n = 4) and medical students (n = 5) during suturing tasks of varying difficulty. Performance data were collected with a motion tracking system. Participants\' hand movements were analyzed for idle time, total operative time, and path length. We hypothesized that there will be shorter idle times for more experienced individuals and on the easier tasks.
RESULTS: A total of 365 idle periods were identified across all participants. Attendings had fewer idle periods during 3 specific procedure steps (P < .001). All participants had longer idle time on friable tissue (P < .005).
CONCLUSIONS: Using an experimental model, idle time was found to correlate with experience and motor planning when operating on increasingly difficult tissue types. Further work exploring idle time as a valid psychomotor measure is warranted.