Chapter 86
- Operating Room Management
- James Kindscher
The operating room (OR) is a major source of revenue for hospitals.
However, these same ORs are also responsible for some of the hospital's greatest
expenses.[1]
Hospital chief executive officers
have become more focused on the contribution margin, or profitability, that comes
out of the OR service, and this change in emphasis has led to the rapid growth and
development of OR management. Previously, there were ill-defined structures for
OR decision making and administration, but now it is becoming common to have a formal
structure for OR management. The science of OR management has also expanded as evidenced
by the increasing number of journal articles devoted to this subject. Anesthesia
and Analgesia now includes a section on economics, education, and health
systems research, with focused articles on OR management. The journal of the Association
of Operating Room Nurses (AORN J) likewise includes
many articles on OR management issues. Another journal, OR
Manager, is devoted to advancing knowledge in this field. The American
Association of Clinical Directors (AACD) is a society formed in 1988 to lead the
development of OR management expertise among anesthesiologists (AACDhq.org). OR
management is also an important topic internationally, with representation by societies
such as Anesthetists in Management in the United Kingdom. Although just over a decade
ago very little information existed concerning OR direction and management, most
hospitals now realize that to be successful, clear-cut, scientific OR management
is crucial.
This chapter will describe the development of OR management structure.
It will also offer information on how to define the complexities of OR function
with the goal of improving OR productivity.
