Anesthesiologists have significantly improved quality of care, but usually anesthesiology groups have focused on efficient delivery of anesthesia care, not efficiency metrics and perioperative governance to drive case volume. In many ways, anesthesiology and hospital goals are now more closely aligned to improve efficiency and throughput at lower cost while improving quality of perioperative care. With changing health care delivery and health system management, optimizing O.R. processes requires an understanding of efficiency metrics. Further, some hospital administrators are evaluated by operational metrics (on-time starts, turnaround times, etc.) included as performance goals in anesthesiology contracts.

Several basic metrics are essential to efficient management of surgical services and include: On-Time Starts, Turnaround Times, Percent Block Utilization, Percent O.R. Utilization (raw and adjusted), Accuracy of Case Scheduling, and Case Time Variability. Metric goals are defined in Table 1 and the effect of...

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