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Applying Performance Frontiers in Operating Room Management

A Tutorial Using Data From an Academic Medical Center

Tsai, Mitchell H., MD, MMM*,†,‡; Breidenstein, Max W., BS*; Flanagan, Timothy F., MD§; Seong, Andrew, MD; Kadry, Bassam, MD, MS; Rizzo, Donna M., PhD#; Urman, Richard D., MD, MBA**

doi: 10.1213/XAA.0000000000000873
Educational Tool

Although the primary goal of operating room (OR) management is to minimize inefficiencies, it may be difficult for OR managers to track metrics when one extrapolates possible scenarios across every OR on a daily basis. With the ability to visualize the statistical relationships to help simplify the analysis of large datasets, a more elaborate efficiency framework can be established using Pareto optimality (or performance frontiers), a multicriteria framework that includes variables that serve as proxies for a variety of outcomes. Applied to OR management, performance frontiers allow for the evaluation of common and well-understood issues of under- and over-utilized time.

From the Departments of *Anesthesiology

Orthopaedics and Rehabilitation (by courtesy)

Surgery (by courtesy), University of Vermont Larner College of Medicine, Burlington, Vermont

§Department of Anesthesiology & Interventional Pain Medicine, Lahey Hospital & Medical Center, Burlington, Massachusetts

Department of Surgery, University of Washington School of Medicine, Seattle, Washington

Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California

#Department of Civil & Environmental Engineering, University of Vermont, Burlington, Vermont

**Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Boston, Massachusetts

Accepted for publication July 3, 2018.

Funding: None.

The authors declare no conflicts of interest.

Address correspondence to Mitchell H. Tsai, MD, MMM, Department of Anesthesiology, University of Vermont Medical Center, 111 Colchester Ave, Burlington, VT. Address e-mail to

© 2018 International Anesthesia Research Society
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