Case scheduling for dummies.

In1995,Drs.Frankl in Dexter and John Tinker published a manuscript on decreasing the cost of care in the postanesthesia care unit (1). Over the following 11 yr, Dr. Dexter has published nearly 100 manuscripts on using mathematical and statistical approaches to optimizing the management of operating rooms. In the process, Dr. Dexter and his frequent collaborators, have defined a new intellectual discipline for our specialty: operating room management. In the process, Dr. Dexter no longer performs liver transplants, his clinical specialty for many years, but devotes himself full time to helping hospitals improve the efficiency of their operating rooms as the Director of the Division of Management Consulting in the Departments of Anesthesia and Health Management and Policy at the University of IA. The tools used to optimize operating room management are arcane: stochastic programming, similarity index, structural equation modeling, Monte Carlo simulation, bin packing algorithms, fuzzy constraints, mean variance analysis, data envelopment analysis, and Bayesian prediction bounds. Although the authors of these articles have worked hard to make the material tractable, nevertheless the articles are hard to read. I have heard from my academic colleagues that few understand the work. The only options for a hospital interested in using these advanced methodolo-gies is to hire Dr. Dexter or one of his colleagues to do the analysis or to teach the hospital's financial analysts or management engineers how to do the analysis. A year ago, I challenged Dr. Dexter to write a " how to " guide for hospitals interested in applying advanced operating room management technologies to surgical case scheduling. Could he condense 10 yr of research and 50ϩ published manuscripts into a guide that did not require gray matter transfusions to understand and implement? My model was the surprisingly well written " For Dummies " series of publications.tralian Hospital " appearing in this issue of Anesthesia & Analgesia (2). Constructed around a real-life example of applying operating room management, the manuscript offers definitions and step-by-step instructions on how to go about improving operating room efficiency, using data routinely gathered during health care delivery. Any physician with a basic understanding of addition, subtraction, multiplication, and division should find the work tractable. Any hospital or anesthesia group interested in improving operating room efficiency should start with this article as a broad overview of the concepts and methodologies. The tables can serve as models for the hospital's information system reports (i.e., " …