Introduction: Operating room (OR) utilization is a key component of economic considerations utilized by OR directors and hospital administrators. Case-start times and turn over time can significantly impact OR utilization and overall economic efficiency. The OR Black Box® (ORBB) is a recording platform that integrates both audio and visual recordings of the operating room and procedure. We utilized information from the ORBB to identify factors that impact OR utilization as well as compliance with safety protocols. Methods: This is a prospective analysis of OR utilization at a tertiary academic health center using a novel data capture device designed for use in the OR. Information from the ORBB of three busy ORs were reviewed from February 7 to September 4 of 2022 to evaluate case on-time starts, block utilization, turnover time, and compliance with pre-procedural ‘time out’ safety checklists. Block utilization was defined as the percentage of block time used to perform surgical procedures. The turn-over times were compared to national averages provided by the ORBB platform wherein the device is currently in utilization. Results: Data from 1,348 cases were included for analysis. Average turnover time for this 142-day period across the three ORs was 46 minutes, which is above the 38-minute national average for all ORs equipped with the ORBB. This increased turnover time equated to 30-31 hours of overtime (calculated as time over the ORBB median turnover time), which amounts to approximately $13,000-186,000 of additional labor costs over the network average. On average, there was 67% block utilization time across the 3 ORs. For all ORs, cases started on time 68% of the time with case delays ranging from 42 to 62 minutes. However, when looking at urology cases only, cases had a 100% on-time rate. From a safety checklist standpoint, 97% of cases had a time-out completed correctly per hospital policy. Conclusions: Data derived from the ORBB allows for assessment of OR utilization and adherence to safety protocols. This data is critical from a health management standpoint to ensure judicious use of hospital resources. Further data is needed to understand factors prolonging turn-over time as well as factors that enable on-time start among services such as urology at our institution in order to optimize OR economic efficiency. SOURCE OF Funding: N/A
