Optimizing Operating Room Efficiency for Primary Hip and Knee Arthroplasty Using Performance Benchmarks

Background: With increasing demand for total hip arthroplasty (THA) and total knee arthroplasty (TKA), maximizing operating room (OR) efficiency is critical. This paper sought to examine the implementation of time benchmarks when performing primary TKA and THA. We hypothesized that implementing benc...

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Main Authors: Koorosh Kashanian, BMSc, Matey Juric, BSc, Tim Ramsay, PhD, Pascal Fallavollita, PhD, Paul E. Beaulé, MD, FAAOS, FRCSC
Format: Article
Language:English
Published: Elsevier 2025-02-01
Series:Arthroplasty Today
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352344124002759
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author Koorosh Kashanian, BMSc
Matey Juric, BSc
Tim Ramsay, PhD
Pascal Fallavollita, PhD
Paul E. Beaulé, MD, FAAOS, FRCSC
author_facet Koorosh Kashanian, BMSc
Matey Juric, BSc
Tim Ramsay, PhD
Pascal Fallavollita, PhD
Paul E. Beaulé, MD, FAAOS, FRCSC
author_sort Koorosh Kashanian, BMSc
collection DOAJ
description Background: With increasing demand for total hip arthroplasty (THA) and total knee arthroplasty (TKA), maximizing operating room (OR) efficiency is critical. This paper sought to examine the implementation of time benchmarks when performing primary TKA and THA. We hypothesized that implementing benchmarks would improve efficiency and the number of joints performed per day. Methods: Two hundred ninety-five patients from 59 OR days were reviewed. All surgeries were performed as outpatients and included 160 females and 135 males; 161 TKA and 134 THA; mean age, 66.1; mean body mass index, 28.6 kg/m2; American Society of Anesthesia, 2. Time points, demographics, and adverse events were recorded. Benchmarks to complete 4 joints in 8 h were: anesthesia preparation time (APT) of <11 min, procedure time of <72 min, anesthesia finish time (AFT) of <21 min, and turnover of <22 min. Results: The percentage of cases meeting individual benchmarks for APT was 50.17%; procedure time was 95.25%; AFT was 99.67%; turnover was 65.25%. The means were: APT 11:00 min, Surgical Prep Time 9:00 min, procedure time 55:00 min, AFT 3:00 min, and turnover 19:00 min. Overall, 98.3% (58/59) of ORs had 4 cases completed within 8 h and 52.5% (31/59) had 5 cases within 8 h. Age, body mass index, and consecutive laterality of surgery were determined to affect the likelihood of meeting benchmarks for case time, APT, and turnover. Conclusions: Establishing time benchmarks permitted the introduction of 5 joint days within an 8-h OR without increasing resource utilization. Factors that influence OR efficiency for high-volume primary hip and knee replacements were identified.
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spelling doaj-art-4a5dc6c0ce34464abd5a1988ee89b0c32025-02-10T04:34:28ZengElsevierArthroplasty Today2352-34412025-02-0131101590Optimizing Operating Room Efficiency for Primary Hip and Knee Arthroplasty Using Performance BenchmarksKoorosh Kashanian, BMSc0Matey Juric, BSc1Tim Ramsay, PhD2Pascal Fallavollita, PhD3Paul E. Beaulé, MD, FAAOS, FRCSC4Division of Orthopaedic Surgery, Department of Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, CanadaDivision of Orthopaedic Surgery, Department of Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, CanadaInterdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, CanadaInterdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada; School of Engineering and Computer Science, University of Ottawa, Ottawa, Ontario, CanadaDivision of Orthopaedic Surgery, Department of Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada; Corresponding author. Paul E. Beaulé, MD, FAAOS, FRCSC, Division of Orthopaedic Surgery, The Ottawa Hospital, 501 Smyth Road, Critical Care Wing, Ottawa, Ontario K1H 8L6, Canada.Background: With increasing demand for total hip arthroplasty (THA) and total knee arthroplasty (TKA), maximizing operating room (OR) efficiency is critical. This paper sought to examine the implementation of time benchmarks when performing primary TKA and THA. We hypothesized that implementing benchmarks would improve efficiency and the number of joints performed per day. Methods: Two hundred ninety-five patients from 59 OR days were reviewed. All surgeries were performed as outpatients and included 160 females and 135 males; 161 TKA and 134 THA; mean age, 66.1; mean body mass index, 28.6 kg/m2; American Society of Anesthesia, 2. Time points, demographics, and adverse events were recorded. Benchmarks to complete 4 joints in 8 h were: anesthesia preparation time (APT) of <11 min, procedure time of <72 min, anesthesia finish time (AFT) of <21 min, and turnover of <22 min. Results: The percentage of cases meeting individual benchmarks for APT was 50.17%; procedure time was 95.25%; AFT was 99.67%; turnover was 65.25%. The means were: APT 11:00 min, Surgical Prep Time 9:00 min, procedure time 55:00 min, AFT 3:00 min, and turnover 19:00 min. Overall, 98.3% (58/59) of ORs had 4 cases completed within 8 h and 52.5% (31/59) had 5 cases within 8 h. Age, body mass index, and consecutive laterality of surgery were determined to affect the likelihood of meeting benchmarks for case time, APT, and turnover. Conclusions: Establishing time benchmarks permitted the introduction of 5 joint days within an 8-h OR without increasing resource utilization. Factors that influence OR efficiency for high-volume primary hip and knee replacements were identified.http://www.sciencedirect.com/science/article/pii/S2352344124002759THATKAEfficiencyBenchmark
spellingShingle Koorosh Kashanian, BMSc
Matey Juric, BSc
Tim Ramsay, PhD
Pascal Fallavollita, PhD
Paul E. Beaulé, MD, FAAOS, FRCSC
Optimizing Operating Room Efficiency for Primary Hip and Knee Arthroplasty Using Performance Benchmarks
Arthroplasty Today
THA
TKA
Efficiency
Benchmark
title Optimizing Operating Room Efficiency for Primary Hip and Knee Arthroplasty Using Performance Benchmarks
title_full Optimizing Operating Room Efficiency for Primary Hip and Knee Arthroplasty Using Performance Benchmarks
title_fullStr Optimizing Operating Room Efficiency for Primary Hip and Knee Arthroplasty Using Performance Benchmarks
title_full_unstemmed Optimizing Operating Room Efficiency for Primary Hip and Knee Arthroplasty Using Performance Benchmarks
title_short Optimizing Operating Room Efficiency for Primary Hip and Knee Arthroplasty Using Performance Benchmarks
title_sort optimizing operating room efficiency for primary hip and knee arthroplasty using performance benchmarks
topic THA
TKA
Efficiency
Benchmark
url http://www.sciencedirect.com/science/article/pii/S2352344124002759
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