Author(s)
Anchith Kota, BA
Doreen Lam, BA
Robert M Brody, MD
Affiliation(s)
Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA (Kota, Lam). Department of Otorhinolaryngology: Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA (Brody).;
Abstract:
Background and Learning Objective
Variations in scheduling practices of case start time as a predictor for operative time in free flap head and neck cases has not yet been well studied in literature.
Study Objective
Identify scheduling factors responsible for variations in case length and end time of head and neck free flap cases.
Design Type
Retrospective Review
Methods
Head and neck flap procedures between 6/2013 and 11/2022 were identified in the electronic medical record at a tertiary academic institution. Operation start time, end time, and day of week were collected. Cases were categorized by start times, with “First Start” cases beginning before 9 AM, “Day Start” between 9 AM and 4 PM, and “Evening Start” after 4 PM.
Results
1702 cases were included (First Start = 980, Day Start = 698, Evening Start = 24). Median case length varied significantly between categorical start time (633 minutes (IQR= 210) vs. 494 minutes (IQR = 176) vs. 244 minutes (IQR = 167), p < 0.001). Differences in median case end time were also significant by those cohorts (17:57 (IQR = 207 minutes) vs 19:28 (IQR = 211) vs 21:24 (IQR = 171), p<.001). Wednesday cases were found to be significantly longer than early-week or late-week cases (668 min, p<.001).
Conclusion
Case lengths were found to be shorter as start time progressed through the day. Evening Start cases were found to have the most variance in end time.