Health Care Management Science

, Volume 9, Issue 4, pp 325–339 | Cite as

Observational study of operating room times for knee and hip replacement surgery at nine U.S. community hospitals

  • Franklin DexterEmail author
  • Lori S. Weih
  • Ross K. Gustafson
  • Linda F. Stegura
  • Mary J. Oldenkamp
  • Ruth E. Wachtel


Knee (N = 185) and hip (N = 140) replacement cases were studied at nine community hospitals in the midwestern United States to determine whether certain management interventions could decrease case durations and reduce labor costs. Substantive (10 min) reductions in operating room (OR) time per case were not associated with: 1) increases in OR staffing, such as the addition of a surgical assistant; 2) complete elimination of all delays; or 3) increases in anesthesiologists’ presence in the ORs. Substantive (10 min) increases in OR time per case were not associated with: 1) reductions in anesthesiologists’ presence in the ORs or 2) changes in case scheduling to run fewer ORs, with some cases starting later in the day. Even if these factors had been associated with differences in OR time per case, any changes resulting from management interventions would still not have reduced labor costs. At these hospitals, OR nursing and anesthesia labor costs were fixed costs, because the OR workload averaged only 5.6 hr of cases per day.


Community hospital Knee replacement Hip replacement Arthroplasty, replacement, knee Arthroplasty, replacement, hip Surgical procedures, operative Surgery Operating rooms Anesthesia department, hospital Anesthesia department, organization & administration 


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Copyright information

© Springer Science + Business Media, LLC 2006

Authors and Affiliations

  • Franklin Dexter
    • 1
    Email author
  • Lori S. Weih
    • 2
  • Ross K. Gustafson
    • 2
  • Linda F. Stegura
    • 3
  • Mary J. Oldenkamp
    • 3
  • Ruth E. Wachtel
    • 4
  1. 1.Division of Management Consulting, Departments of Anesthesia and Health Management & PolicyUniversity of IowaIowa CityUSA
  2. 2.Knowledge ServicesVHA Upper MidwestIrvingUSA
  3. 3.Performance ImprovementVHA Upper MidwestIrvingUSA
  4. 4.Division of Management Consulting, Department of AnesthesiaUniversity of IowaIowa CityUSA

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