Consecutive Surgeon and Anesthesia Team Improve Turnover Time in the Operating Room

Sarpong, Kwadwo; Kamande, Stanley; Murray, Jerome; Wiley, Alynna; Bhatnagar, Akrita; Dowlati, Ehsan; Nair, M. Nathan

doi:10.1007/s10916-022-01802-6

Cited by 7 publications

(6 citation statements)

References 18 publications

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“…Although not a marker of case difficulty, it may be used as a gross marker of patients’ medical complexity. It was not a significant factor related to TOT in our multivariate regression; however, in Sarpong et al, it was a significant variable when comparing ASA level 2, 3, and 4 patients [ 5 ]. This is likely related to difficult or longer intubation and/or extubation times.…”

Section: Discussionmentioning

confidence: 74%

“…These factors go along with the idea that there is no interruption in staffing within the OR and there is continuity of the care team during and between cases. These variables have been previously discussed and analyzed [ 5 ]. Patient ASA status also included.…”

Section: Discussionmentioning

confidence: 99%

“…Case difficulty is a variable not captured in our data collection that may influence TOT. However, subspecialty-specific data have been analyzed in a previous study and demonstrate that specialties such as transplant and urology have significantly higher TOTs compared specialties such as orthopedics and otolaryngology that have lower TOT [ 5 ]. Finally, TOT is influenced by multiple factors and there are other factors that may be at play which are not as easily captured in a retrospective study, including delays related to medical clearance, patient transport, and technical or equipment issues that may be encountered within or in between OR cases.…”

Section: Discussionmentioning

confidence: 99%

“…The influence of OR staffing on TOT has previously been examined by assessing the impact of efficiency trainings, as well as the benefits of a nursing team during TOT [4]. Recent publications have reported that maintaining the same team for consecutive cases with the same surgeon independently predicted lower TOT [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

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Turnover Time Between Elective Operative Cases: Does the Witching Hour Exist for the Operating Room?

et al. 2022

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Background Efficient resource management in the operating room (OR) contributes significantly to healthcare expenditure and revenue generation for health systems. We aim to assess the influence that surgeon, anesthesiology, and nursing team assignments and time of day have on turnover time (TOT) in the OR. Methods We performed a retrospective review of elective cases at a single academic hospital that were completed between Monday and Friday between the hours of 0700 and 2359 from July 1, 2017, through March 31, 2018. Emergent cases and unplanned, add-on cases were excluded. Data regarding patient characteristics, OR teams, TOT, and procedure start and end times were collected and analyzed. Results A total of 2174 total cases across 13 different specialties were included in our study. A multivariate regression of relevant variables affecting TOT was performed. Consecutive specialty ( p < 0.0001), consecutive surgeon ( p < 0.0001), anesthesiologist ( p < 0.0001), and prior case ending before 1400 ( p < 0.0001) were independent predictors of lower TOT. A receiver operating characteristic analysis demonstrated an area under the curve of 0.848 and a cutoff of 1400 having the highest sensitivity and specificity for TOT difference. Conclusions TOT can be significantly affected by the time of the day the procedure is performed. Staffing availability during late procedures and the differences in how OR team staff are scheduled may affect OR efficiency. Additional studies may be needed to determine the long-term implications of changes implemented to decrease organizational operational costs related to the OR.

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Turnover Time Between Elective Operative Cases: Does the Witching Hour Exist for the Operating Room?

et al. 2022

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“…In attempts to shorten turnover time, others have tried implementing mobile applications,6 designated specialised OR teams,7 turnover task cards,8 remote video auditing with real-time feedback,9 and other published process improvement initiatives 10–14. However, despite these and other attempts, turnover time continues to be a frustratingly difficult problem to solve at many if not most institutions.…”

Section: Introductionmentioning

confidence: 99%

Surgical pit crew: initiative to optimise measurement and accountability for operating room turnover time

Goldhaber,

Schaefer,

Martinez

et al. 2023

BMJ Health Care Inform

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Background and objectivesTurnover time (TOT), defined as the time between surgical cases in the same operating room (OR), is often perceived to be lengthy without clear cause. With the aim of optimising and standardising OR turnover processes and decreasing TOT, we developed an innovative and staff-interactive TOT measurement method.MethodsWe divided TOT into task-based segments and created buttons on the electronic health record (EHR) default prelogin screen for appropriate staff workflows to collect more granular data. We created submeasures, including ‘clean-up start’, ‘clean-up complete’, ‘set-up start’ and ‘room ready for patient’, to calculate environmental services (EVS) response time, EVS cleaning time, room set-up response time, room set-up time and time to room accordingly.ResultsSince developing and implementing these workflows, measures have demonstrated excellent staff adoption. Median times of EVS response and cleaning have decreased significantly at our main hospital ORs and ambulatory surgery centre.ConclusionOR delays are costly to hospital systems. TOT, in particular, has been recognised as a potential dissatisfier and cause of delay in the perioperative environment. Viewing TOT as one finite entity and not a series of necessary tasks by a variety of team members limits the possibility of critical assessment and improvement. By dividing the measurement of TOT into respective segments necessary to transition the room at the completion of one case to the onset of another, valuable insight was gained into the causes associated with turnover delays, which increased awareness and improved accountability of staff members to complete assigned tasks efficiently.

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The impact of verbal goal setting on operating room turnover time: a randomized trial

Matz,

Dutta,

Tsivian

et al. 2023

Int Urogynecol J

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Consecutive Surgeon and Anesthesia Team Improve Turnover Time in the Operating Room

Cited by 7 publications

References 18 publications

Turnover Time Between Elective Operative Cases: Does the Witching Hour Exist for the Operating Room?

Turnover Time Between Elective Operative Cases: Does the Witching Hour Exist for the Operating Room?

Surgical pit crew: initiative to optimise measurement and accountability for operating room turnover time

The impact of verbal goal setting on operating room turnover time: a randomized trial

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