Cadence. A new case can start every max( (prep + operative + close + turnover) ÷ 2, operative + 5 min walk ). If the surgeon term is larger, the model is surgeon-limited (rooms feed faster than the surgeon can operate); if the room term is larger, the model is room-limited (the surgeon waits between cases).
Cases per day. Hard stop at end time — only cases whose patient is out of the room by then count. The first is out at prep + operative + close; one more lands every cadence after. Turnover after the last case is ignored.
Surgeon use. Operative minutes actually performed ÷ the staffed day (cases × operative ÷ total minutes).
Room utilization. For each case, occupied time is capped at end of day: min(case start + full cycle, end time) − case start. A last case whose turnover runs past end time is only counted up to end time, correctly penalising Room B’s later start on room-limited days.
Assumptions. The surgeon is needed only skin-to-skin; prep, emergence and turnover run in parallel in the other room with a second team. Times are fixed — no variability, delays, add-ons or emergencies — so this is a best-case ceiling. The multiplier never quite reaches 2×, since the first case’s prep is never hidden and the last case needs its full tail.