Concurrent Surgery at UMass Memorial Health Care

Abstract

Purpose: Concurrent and overlapping surgery scheduling, a common practice at academic medical centers, has received recent attention in the media for being potentially harmful to patients. In light of these recent events, the executive staff and Board of Trustees at UMass Memorial Health Care wished to better understand the prevalence of the practice at their medical center and what risk factors may affect this prevalence. Methods: Surgery scheduling data on all surgeries from 2013-2015 (inclusive) was selected for analysis. Concurrent surgery was defined as any time one attending surgeon was responsible for two open incisions at one time. Scheduled overlapping surgery was defined as any time two procedures were electively scheduled to overlap for the same surgeon. Prevalence ratios were calculated for the total number of concurrent surgeries over the three-year time span and stratified by location, specialty, and surgeon. Multivariate logistic regression was used to calculate odds-ratios for relevant risk factors. Results: In total, 87,980 procedures were performed from 2013-2015, of which 84,881 were eligible for analysis. During this time span, there were 1,070 concurrent surgeries (1.3%) across all three UMass campuses. The median concurrent time varied from 12.5 minutes (range 0-327 minutes) at the Hahnemann campus to 14 minutes (range 0-250 minutes) at the Memorial campus to 50 minutes (range 0-985 minutes) at the University campus. Orthopedics accounted for the most concurrent surgeries at each campus. Of the risk factors investigated, scheduled overlapping surgeries and the specific surgeon significantly increased the risk of causing a concurrent surgery at each campus. Interestingly, the add-on cases did not pose a significantly increased risk of causing concurrent surgery. Conclusions: Overall, 1.3% of UMass Memorial Health Care’s surgical cases are concurrent by our definition, and scheduling surgeries to overlap on the elective surgery schedule as well as the surgeon mix significantly increased the risk of a concurrent surgery occurring.