• Franklin Dexter, Richard H Epstein, and Donald H Penning.
• Department of Anesthesia, University of Iowa, United States of America. Electronic address: Franklin-Dexter@UIowa.edu.
• J Clin Anesth. 2020 Feb 1; 59: 18-25.

Study ObjectiveWe consider the influence of the tardiness of first-case of the day start times on the minutes that rooms finish late for procedural suites with relatively interchangeable rooms and mean workloads ≅ 7 h per room, thus regularly filling 8-hour of allocated time.DesignHistorical cohort of N = 331 workdays of data.SettingGastrointestinal endoscopy suite.Main ResultsBy unadjusted analyses, reductions in the number of first-cases of the day starting ≥5 min late were associated with less minutes that the day's cases ended beyond the allocated 8 h. However, there were no significant relationships in adjusted analyses, controlling for the daily total hours of cases and turnovers ("workload") or the daily caseload of elective cases. There also were no significant relationships in adjusted analyses between the minutes of cases ending beyond the allocated 8 h and either the count of cases starting ≥15 min late or the mean minutes of case tardiness. The differences between unadjusted and adjusted results were explained by slight positive associations between the count of first-cases starting ≥5 min late and both the daily workload and caseload. Days with less hours of cases had significantly fewer cases starting near simultaneously at the beginning of the day; the same was true for days with fewer total cases.ConclusionsFor procedural suites with relatively interchangeable rooms and mean workloads ≅ 7 h per room, reducing tardiness of first-case of the day start times does not result in beneficial reductions in over-utilized time. The focus of improving on-time starts for the first-cases of the day should be on services with mean workloads that exceed the minimum scheduled duration of the workday.Copyright © 2019 Elsevier Inc. All rights reserved.

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