The Real Cost of Underutilised Clinical Rooms

The Utilisation Gap Is Well Documented — and Persistent

Operating theatre utilisation has been studied extensively across health systems, and the findings are remarkably consistent regardless of country or payer model. Studies published in the British Journal of Anaesthesia and Health Affairs both report average theatre utilisation rates in the 60–80% range against a typically used 85% efficiency benchmark — with idle time concentrated in late-morning and late-afternoon "gap" slots that are individually too short to book a full procedure but collectively represent substantial lost capacity.

The same pattern holds for outpatient clinical rooms and diagnostic suites: a well-cited operations research finding is that the primary driver of underutilisation is not insufficient demand, but scheduling friction — the mismatch between how slots are blocked in advance and how actual demand and procedure duration vary case by case.

Why Static Scheduling Fails to Close the Gap

Most scheduling systems still allocate fixed-duration blocks based on historical averages by procedure type. The research literature on surgical case duration prediction has repeatedly shown that procedure duration variance is large enough — driven by patient-specific factors like BMI, comorbidity burden, and surgeon-specific technique — that average-based blocking systematically either overbooks (causing cascading delays) or underbooks (leaving rooms empty) on a large share of days.

Workforce and capacity intelligence approaches that incorporate patient-specific and surgeon-specific prediction — rather than procedure-type averages — have been shown in academic medical center pilots (notably at Stanford and Duke) to reduce both overrun-related delays and idle-time gaps simultaneously, because the underlying problem in both cases is the same: scheduling against an average masks the variance that actually drives inefficiency.

The Financial Magnitude

Published cost-per-minute estimates for operating theatre time in private healthcare settings typically range from the low hundreds to over a thousand currency units per minute depending on specialty and region, when staffing, equipment amortisation, and opportunity cost are included. At even a conservative 20% daily underutilisation rate, the annualised cost of unused capacity in a mid-sized surgical department is frequently larger than the cost of the scheduling and capacity intelligence system that would close the gap — which is the central economic argument for treating capacity optimisation as a recurring operational investment rather than a one-time efficiency project.