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Difficulty: HardResolve the Paradox

Two years ago, St. Jude Medical Center implemented an automated scheduling system across its central surgical suites to minimize operating room downtime. Over the following two years, the average turnover time—the duration required to clean, restock, and prepare an operating room between consecutive procedures—decreased by more than twenty percent. Moreover, the average number of hours per day that operating rooms were staffed and available remained unchanged, and the rate of last-minute surgical cancellations declined slightly. Nonetheless, the total number of surgical procedures completed per operating room per month decreased substantially.

Which of the following, if true, most helps to resolve the apparent discrepancy in the information above?

  1. A
    The hospital hired dedicated sanitation teams whose sole responsibility was sterilizing operating suites immediately after each operation concluded.
  2. B
    Surgeons performing procedures in the central suites adopted new laparoscopic techniques that significantly reduced the average operating time required for standard operations.
  3. Concurrent with the software rollout, minor and routine procedures were relocated to a newly opened outpatient clinic, leaving the central suites to handle predominantly complex surgeries that required far longer operative times.Answer
  4. D
    Patients who underwent surgery in the central surgical suites during the two-year period reported significantly higher overall satisfaction with their pre-operative care.
  5. E
    Hospital administrators initially underestimated the ongoing licensing and technical maintenance fees associated with operating the new automated scheduling software.

Answer

The statement explaining that routine procedures were shifted to an outpatient clinic, leaving only complex surgeries requiring far longer operative times in the central suites, resolves the paradox.
The correct answer provides the missing variable in the mathematical relationship between operating room time and total procedure volume: procedure duration. If the central suites began handling predominantly complex surgeries that each took substantially longer to complete, each operating room would accommodate fewer total procedures per month, even though the downtime between those procedures was reduced.

Step-by-Step Solution

1
Identify the conflicting facts in the stimulus
Fact 1: Turnover time between operations fell by over 20%, available staffed hours stayed constant, and cancellations dropped. Fact 2: Total completed surgical procedures per room per month decreased substantially.
Resolving a paradox requires precisely isolating the two seemingly contradictory trends.
2
Determine what missing factor links turnover time and total procedure counts
Total procedure capacity depends on turnover time, total operating hours, and the average duration of each surgical procedure.
Faster turnover and constant staffed hours would produce fewer total surgeries only if each surgery consumed significantly more operating time.
3
Evaluate the choices to find the causal mechanism that allows both facts to coexist
The shift toward longer, highly complex surgical cases directly explains how total procedure counts dropped despite faster turnover and constant room availability.
A valid resolution must bridge the discrepancy without contradicting any established premise.

Key Concept

Reconciling Discrepant Operational Rates and Volumes via Casemix Duration Shifts
Estimated Time:1m 30s
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Topics

Resolve the Paradox

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