It was with profound interest that we read the commentary written by Tamas Fixler and James G. Wright in the August 2013 issue of the Canadian Journal of Surgery. The commentary deals with the identification and measurement of operating room (OR) performance indicators, addressing the variation among hospitals in terms of which indicators are collected and analyzed.
Common definitions among hospitals are essential for external benchmarking. Although the authors identified 8 indicators as the most critical for monitoring OR performance in 15 children’s hospitals in Canada, definitions for these indicators vary in literature and across hospitals.
In the Netherlands, OR departments of all 8 university medical centres (UMCs) established a nationwide benchmarking collaboration in 2005 that is still active today. The objective of the collaboration is to improve OR performance by learning from each other through exchanging best practices. Each UMC provides records for all performed surgical cases to a central OR benchmark database. This extensive database, presently comprising more than 1 million surgical case records, is used to calculate key performance indicators related to the utilization of OR capacity. The database is also used for multicentre research on OR scheduling topics and OR efficiency.
At the start of this collaboration, a set of performance indicators, particularly from a utilization perspective, was identified. Next, data definitions of time periods and methods of registration, as well as definitions of performance indicators, were harmonized among all benchmarking participants, a process that took nearly 2 years. An independent data management centre enters the longitudinal data collection in the central OR benchmark database. This centre provides professional expertise by facilitating and processing data, and by performing reliability checks before data are deemed ready for analysis.
Our collaboration frequently meets to discuss data analysis results and explore processes and practices beyond the data. Through promoting dialogue among UMCs, a learning environment has been created.
Footnotes
Competing interests: None declared.