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Pediatric Plastic Surgery Operating Room Block-time Utilization: A Casualty Of Illness

Samantha G. Maliha, MD MS; Madeleine K. Bruce, BA; Miles J. Pfaff MD MHS; Erin A. Anstadt, MD; Eva Roy, BA; Jesse A. Goldstein, MD; Joseph E. Losee, MD
University of Pittsburgh
2021-01-31

Presenter: Samantha G. Maliha

Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. The program director is responsible for making a statement within the confines of the box below specific to how much of the work on this project represents the original work of the resident. All authors/submitters of each abstract should discuss this with their respective program director for accurate submission of information as well as the program director's approval for inclusion of his/her electronic signature.

Director Name: Vu Nguyen, MD

Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction

Introduction:
Optimizing operating room (OR) utilization is a critical component of health care system efficiency. Few international institutions have analyzed OR cancellation for adult patients, yet there is a paucity of literature in pediatrics. The purpose of our study was to analyze the effect of OR cancellation on raw utilization of OR block time in the pediatric plastic surgery department of a children's hospital.

Methods:
We retrospectively reviewed cases of 4 plastic surgeons at a tertiary pediatric hospital between 2018-2019. Data collected included patient demographics, type of surgery, time of cancellation, reason for cancellation, length of surgery, and minutes of block time allotted to each surgeon per year.

Results:
Among all 4 surgeons, 28.2% of cases were cancelled, 37.2% of scheduled time was lost, and 21.3% of block time was lost due to cancellation over one year. Patients of surgeon A and D were more likely to cancel due to reasons classified as "other," such as failure of NPO or a last-minute decision to forego elective surgery (33.3% and 37.2%, respectively). Patients of surgeon B and C were more likely to cancel due to illness (67.9% and 36.4%, respectively). Notably, surgeon D had the highest rate of case cancellation (9.1%) and was most likely to perform procedures under local sedation without general anesthesia.

Conclusions:
OR utilization in the pediatric population is largely understudied. However, cancellations negatively impact raw utilization times. Future directions include exploring whether particular surgeon characteristics are linked to rate of cancellations.

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