Original Research Articles

Can we predict when operating lists will finish in a regional Queensland hospital?

Winner of the Co-Op Bookshop Prize for Best Academic Article in this issue of the AMSJ


Background: Over-running operating lists are a common cause of same-day cancellations of surgery, while under-running operating lists are a common cause of wasted health resources due to the fixed costs of operating suites. The predominant cause of operating lists running off-schedule is not known, but it is believed that if due to booking problems, it should be possible to predict when a list will over- and under-run. Aims: To understand the prevalence of cancellations, over- and under-running operating lists in a regional Queensland hospital, and to test whether over- and under-running lists can be predicted. Methods: A sample of 120 operating lists was prospectively obtained and each list timed from start to finish. A predicted duration was calculated for each list by summing the average durations for each of the operations on the list (including anaesthetic and turn-over durations), derived from past surgical records. Results: Twenty-eight percent of lists suffered a cancellation, of which 79% were predicted to over-run their scheduled duration. Of the lists that did not suffer a cancellation, 45% over-ran, of which 84% were predicted; and 37% under-ran, of which 84% were predicted. Conclusion: The large proportion of predicted over- and under-runs support the hypothesis that booking problems are the main causes of operating lists running off-schedule, as opposed to other factors affecting surgical duration that the model would not have accounted for. This suggests that operating lists running off-schedule can potentially be avoided. Further study is warranted to investigate the reasons behind over- and under-booking.