A BUDGET-NEUTRAL UTILIZATION-CREDIT INCENTIVE TO IMPROVE OPERATING ROOM CAPACITY MANAGEMENT: A PRE-POST STUDY
Author(s)
Melana Elliot, BS1, Peter Frasco, MD1, Molly Kraus, MD1, Stacy Martinez, MPA2, Irving A Jorge, MD1, David Etzioni, MD1.
1Mayo Clinic College of Medicine and Sciences, Phoenix, AZ, USA, 2Mayo Clinic, Phoenix, AZ, USA.
1Mayo Clinic College of Medicine and Sciences, Phoenix, AZ, USA, 2Mayo Clinic, Phoenix, AZ, USA.
OBJECTIVES: Delayed release of unused operating room (OR) block time reduces scheduling flexibility, limits efficient capacity use, and may delay patient access. We evaluated whether a budget-neutral, non-monetary incentive embedded within an existing OR utilization metric increased timely release of unused block time and improved OR utilization.
METHODS: We performed a retrospective quasi-experimental pre-post study at a 33-OR academic hospital comparing pre-intervention (April 2022-March 2023) and post-intervention (April 2023-March 2024) periods. Surgical divisions received 4 hours of utilization credit for each allocated OR block start released at least 28 days before the scheduled date. Among 16,362 allocated block starts across 18 surgical divisions, outcomes were the proportion of released blocks surrendered at least 28 days before the scheduled date and overall primetime OR utilization. Comparisons used Pearson’s chi-square tests and logistic regression adjusted for surgical division, odds ratios were converted to approximate relative risks (RRs) for interpretability.
RESULTS: After implementation, total block releases increased 41% (610 to 859). The proportion of early releases among released blocks increased from 34.3% (209/610) to 53.1% (456/859), an absolute improvement of 18.8 percentage points (p less than 0.001). The likelihood of early release increased among released blocks (RR 1.55, 95% CI 1.45-1.65) and across all allocated block starts (RR 2.11, 95% CI 1.85-2.41). Overall primetime OR utilization increased from 76% to 81% following the intervention. No additional financial incentives or OR capacity expansions were required.
CONCLUSIONS: In a complex academic OR ecosystem, the introduction of a utilization-credit incentive was associated with significantly earlier release of unused OR block time and improved primetime OR utilization. Incentive-based scheduling strategies aligned with existing operational performance metrics may enhance operational efficiency, hospital capacity management, and patient access.
METHODS: We performed a retrospective quasi-experimental pre-post study at a 33-OR academic hospital comparing pre-intervention (April 2022-March 2023) and post-intervention (April 2023-March 2024) periods. Surgical divisions received 4 hours of utilization credit for each allocated OR block start released at least 28 days before the scheduled date. Among 16,362 allocated block starts across 18 surgical divisions, outcomes were the proportion of released blocks surrendered at least 28 days before the scheduled date and overall primetime OR utilization. Comparisons used Pearson’s chi-square tests and logistic regression adjusted for surgical division, odds ratios were converted to approximate relative risks (RRs) for interpretability.
RESULTS: After implementation, total block releases increased 41% (610 to 859). The proportion of early releases among released blocks increased from 34.3% (209/610) to 53.1% (456/859), an absolute improvement of 18.8 percentage points (p less than 0.001). The likelihood of early release increased among released blocks (RR 1.55, 95% CI 1.45-1.65) and across all allocated block starts (RR 2.11, 95% CI 1.85-2.41). Overall primetime OR utilization increased from 76% to 81% following the intervention. No additional financial incentives or OR capacity expansions were required.
CONCLUSIONS: In a complex academic OR ecosystem, the introduction of a utilization-credit incentive was associated with significantly earlier release of unused OR block time and improved primetime OR utilization. Incentive-based scheduling strategies aligned with existing operational performance metrics may enhance operational efficiency, hospital capacity management, and patient access.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HSD100
Topic
Health Policy & Regulatory, Health Service Delivery & Process of Care, Organizational Practices
Disease
No Additional Disease & Conditions/Specialized Treatment Areas