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University of Iowa News Release

Feb. 19, 2003

Educational Tools Help Operating Room Staff Increase Efficiency

Rising health care costs are an area of great concern in the United States. Recent reports have shown that U.S. health care costs jumped 8.7 percent between 2000 and 2001, the largest increase this decade. U.S. health care spending totaled $1.4 trillion in 2001.

Increasing productivity and efficiency is one way to help reduce these costs, and University of Iowa researchers have developed tools to help health care organizations determine the most efficient way to use their operating room resources.

"The science for optimizing operating room efficiency within any particular health care organization is extremely well developed and mature," explained Franklin Dexter, M.D., Ph.D., UI associate professor of anesthesia and director of the department's division of management consulting. "The challenge is how to communicate that information in such way that staff can actually use it to increase operating room efficiency."

Over the past decade, Dexter and his colleagues have developed computational methods that analyze operating room staffing and scheduling data and calculate the most efficient way for a hospital to use its operating room and anesthesia resources. Their studies prove that implementing the science can result in significant reductions in staffing costs. However, while the scientific papers present proof that the methodology works, they do not describe how to implement the findings in a practical way. So, the UI researchers have taken the next step and developed a service, which teaches organizations how to apply the science to their own situation.

"Our new service is designed to address the problem of how to communicate to a large organization how to use the science to optimize operating room efficiency within their particular and unique setting," Dexter said. "We take real data from a hospital and produce different scenarios that deal with decisions that will crop up for that organization."

These scenarios take the form of four to six brief sentences that walk operating room staff, including managers, surgeons and anesthesiologists through the logic of a decision and help them determine the best way to increase their efficiency. The scenarios help people understand how to make the decisions that will produce higher levels of operating room efficiency.

The scenarios provide a tool that allows an organization to translate the science into real actions. They perform a similar function to a textbook but they have several advantages over that more traditional learning tool. For example, the scenarios are less dense; people are more likely to work through several short scenarios than are likely to read an entire textbook, and the scenarios are specific to each organization unlike a textbook, which could only describe general cases. They also can point out gaps in an organization's information, which need to be filled in order to make good decisions.

"The scenarios are highly customized educational material for the organization, teaching them how to use the science that we have developed," Dexter said. "They are very short, very concrete, and very obvious. People read the scenario and very quickly, on their own, figure out 'so that's how I make the decision.'"

Dexter stressed the importance of customization of the scenarios. He explained that if a scenario is unrelated to everyday reality, it is less meaningful to the people using it.

Different scenarios cover different topics; some cover decisions on the day of surgery, some cover scheduling cases the day before surgery, others cover urgent surgical cases or scheduling cases weeks before day of surgery or allocating operating room time months before the day of surgery. An organization receives around 100 scenarios all based on their own data, which are relevant for that particular organization.

"I think this tool can be applied to any and all surgical suites worldwide," Dexter said.

For more information about the scenarios and about Dexter's research on increasing efficiency in health care organizations, visit

University of Iowa Health Care describes the partnership between the UI Roy J. and Lucille A. Carver College of Medicine and UI Hospitals and Clinics and the patient care, medical education and research programs and services they provide. Visit UI Health Care online at

STORY SOURCE: University of Iowa Health Science Relations, 5141 Westlawn, Iowa City, Iowa 52242-1178

CONTACT: Jennifer Brown, (319) 335-9917