Monitoring operating room performance with control charts: findings from a Greek public hospital

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). Design: 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 healthcare managers. Setting: A large Greek public hospital. Participants: Real-world data captured on daily basis from January 2015 to November 2017. Intervention: 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. Conclusion: 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.