Surgical block time satisfaction: A multi-institutional experience across twelve surgical disciplines

Background: Block scheduling optimizes utilization of valuable operating room (OR) resources. While most studies investigate block scheduling and surgical workloads from a systems perspective, surgeons’ perspectives have yet to be assessed. Such information could provide systems-level solutions to help mitigate prevalent issues such as surgeon burnout. This study surveyed attending surgeons on satisfaction with OR block scheduling and to assess the impact of surgeon characteristics on OR block allocation/satisfaction. Methods: This was a cross-sectional investigation of attending surgeons at three academic/tertiary-care hospitals. Sensitivity analyses were completed to evaluate for nonresponse bias. Surgeons’ allocated block times versus their workloads, as well as surgeons’ satisfaction with their block times, were investigated. Associations between survey responses and surgeon characteristics were evaluated using univariable and multivariable analyses. Results: Surveys were emailed to 264 surgeons, of whom 159 (60.2%) participated. Nonresponse bias was not found to impact study results. Senior faculty (odds ratio [OR]:2.4; 99.5% confidence interval [CI]:1.1-5.2; p=0.002) and fellowship-trained surgeons (OR:9.5; 99.5% CI:3.7-24.4; p<0.0001) had significantly greater odds of receiving desirable Monday-Thursday blocks. Senior faculty were also significantly more likely to have adequate block time for their reported workloads (OR:3.1; 99.5% CI:2.1-4.2; p=0.002). Female gender was significantly negatively correlated with number of allocated block hours (standardized coefficient:-2.6, standard error:0.5, p=0.002). Female surgeons were also significantly less likely to have adequate block time for their reported workloads (OR:0.3, 99.5% CI:0.1-0.5, p=0.004). A majority of respondents believed that inadequate block time impacted personal/career goals and contributed to burnout (62%). Conclusions: Surgical block time allocation and satisfaction at three academic centers varied by surgeons’ gender, position, and training. Furthermore, our results demonstrated that surgical block scheduling can substantially impact surgeons’ personal/career goals and burnout levels. Greater transparency and incorporation of surgeon input into block allocation may improve surgeons’ professional development and patient care.