The operational impact of an acute care surgical service on operating room metrics

The data on the financial and operational impact of an Acute Care Surgery (ACS) service is equivocal. Multiple stakeholders, mostly surgeons and anesthesia health care providers, envision themselves as caretakers of a precious, expensive service line. Although previous studies have examined the impact of an ACS service model on the time to theater metric, there are no studies examining the impact of an ACS service on the operating room (OR) from the perspective of an OR manager. In this study, we examine the impact of an ACS service on operating room utilization and general surgery services using several OR management metrics: elective in-block utilization, after-hours utilization, and opportunity-unused time. Using these metrics to study one year pre- and one year post-ACS service implementation at our institution we were able to demonstrate more effective use of an OR (fixed cost) and a decrease in after-hours operating time for the non-ACS general surgeons (variable cost). We propose the use of such OR management metrics as an integral component of service line implementation analysis.