RVU Target Feasibility Calculator

• Block Requirement: number of blocks required to reach the RVU target. Blocks are of the length specified in the Block Size field.
• Number of Cases: number of cases required to reach the RVU Target. It is dependent only on the RVU Target.
• Net Case Time: total number of hours spent operating, not including turnover time. It is dependent only on the RVU Target.
• Net Turnover time: sum of all turnovers.
• Net Operating Room Time: inclusive of both case time and turnovers.
• Hourly RVUs (Surgeon): total RVUs divided by net operating time. It is dependent only on Block Size and Turnover Time.
• Hourly RVUs (Admin): total RVUs divided by the sum of reserved block time and overtime block utilization. It is dependent only on Block Size and Turnover Time.

Ten surgical specialties are documented in ACS NSQIP. Subspecialties within these ten are not represented at this time. Interventional Radiology was excluded due to small sample size.

Case-Mix complexity refers to the relative difficulty of cases performed by a surgeon.

• Cases were grouped by principal procedure, and each group was split into three evenly sized tertiles (Low, Medium, High) by operating time.
• The distribution of principal procedures is roughly consistent across tertiles.
• RVUs per case increased across tertiles with increasing complexity, even though stratification did not explicitly account for RVUs; this finding lends credence to the heuristic as a rough measure of complexity.
• A fourth category (All) includes all case complexities together.

Cases are scheduled in concert with other cases which present around the same time. The number of cases that present and are scheduled at the same time determines the scheduling flexibility.

• Increased flexibility to schedule cases is associated with improved efficiency of block utilization.
• An annual benchmark is included to reference characteristics of the theoretical optimum schedule, which is possible when an annual caseload is scheduled at once with unlimited scheduling flexibility.

The number of RVUs to be attained. The model is validated for RVU targets in the range of 3000 to 12000.

The length of one day's allocated elective operating time, termed a block.

• The model is validated for block sizes in the range of 4 to 12 hours.
• Notably, cases are not scheduled to exceed block length unless a single case is longer than the block.
• Hence, longer blocks permit better block utilization than two blocks of half length, and the two scenarios are not equivalent despite having equal reserved block time (e.g., an 8 hour block allows for better block utilization than two 4 hour blocks).

Time between skin closure at the end of one case and skin incision at the start of the next case. This time accounts for anesthetic emergence and induction as well as other activities such as OR cleaning and patient transport.

• The model is validated for turnover times in the range of 0 to 90 minutes for most metrics except those pertaining to hourly RVUs, in which case the validated lower bound is 10 minutes.