Improved utilization of operating room time for trainee cataract surgery in a public hospital setting

Kang, Jessica; Padmanabhan, Sriranjani; Schallhorn, Julie M.; Parikh, Neeti; Ramanathan, Saras

doi:10.1016/j.jcrs.2017.11.014

Cited by 7 publications

(17 citation statements)

References 5 publications

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“…Segment analysis showed a significant difference in values for both entry and exit lags compared to published benchmarks specific for cataract surgery ( Table 4 and Figure 2 ). 18 Likewise, comparing study results with another study’s proposed targets 11 showed that entry lag was increased by as much as seven minutes, while exit lag and turnover time were low, similar to the benchmark comparisons done previously. Furthermore, the operating time for phacoemulsification was also higher, 42.9 minutes vs. 30 minutes set as target in the study.…”

Section: Resultssupporting

confidence: 61%

“…Furthermore, the operating time for phacoemulsification was also higher, 42.9 minutes vs. 30 minutes set as target in the study. 11 …”

Section: Resultsmentioning

confidence: 99%

“…The ideal times they set for each segment were 15 minutes for entry lag, 30 minutes for surgery, 5 minutes for exit lag, and 20 minutes for turnover time. 11 …”

Section: Discussionmentioning

confidence: 99%

“…At the end of the intervention, they could decrease overall case time from 55 to 46 minutes, allowing for 13 cases in a ten-hour workday. 11 …”

Section: Discussionmentioning

confidence: 99%

“…Further analysis was done using Stata 13. Benchmarking was done through comparison with published target values, 11 , 18 with the assumption that benchmarking data were normally distributed, where the median resembles the mean, the one-sample test of means was performed to compare current with said data. The significance level for all sets of analyses was set at a p-value of less than 0.05 using two-tailed comparisons.…”

Section: Methodsmentioning

confidence: 99%

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<p>Efficiency of Operating Room Processes for Elective Cataract Surgeries Done by Residents in a National University Hospital</p>

Umali

Castillo

2020

OPTH

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Purpose Operating room processes must be efficient to boost profitability and minimize cost while retaining surgical care quality. This study aims to assess operating room efficiency for resident-performed elective phacoemulsification surgeries done under local anesthesia by measuring different key performance indicators and comparing this with international benchmark data. Patients and Methods This is a prospective cross-sectional study done in the Department of Ophthalmology of the Philippine General Hospital, the National University Hospital. The operating room milestones were noted and recorded by a single third-party observer in randomly selected operating rooms from April to June 2019. Results Fifty-six phacoemulsification cases in randomly selected rooms fulfilling both inclusion and exclusion criteria were observed. None of the cases started on or before the scheduled 6:30 a.m. cutting time, with an average of 34 (SD 8.53) minutes late. Entry lag was above the median, while exit lag and turnover time were above the 95th percentile compared to benchmarking data. Segment analysis also showed an increased entry lag (35.11% vs 21.5%), significantly higher than benchmarks (t: 10.99, df: 55, p<0.01). Comparison with proposed targets in other studies also showed an increased time for entry lag. Conclusion This study determined that entry lag is the performance indicator that should be addressed to improve efficiency. A multidisciplinary approach and group goal-setting are needed to implement changes in the operating room.

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Section: Resultssupporting

confidence: 61%

“…Furthermore, the operating time for phacoemulsification was also higher, 42.9 minutes vs. 30 minutes set as target in the study. 11 …”

Section: Resultsmentioning

confidence: 99%

“…The ideal times they set for each segment were 15 minutes for entry lag, 30 minutes for surgery, 5 minutes for exit lag, and 20 minutes for turnover time. 11 …”

Section: Discussionmentioning

confidence: 99%

“…At the end of the intervention, they could decrease overall case time from 55 to 46 minutes, allowing for 13 cases in a ten-hour workday. 11 …”

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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<p>Efficiency of Operating Room Processes for Elective Cataract Surgeries Done by Residents in a National University Hospital</p>

Umali

Castillo

2020

OPTH

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Evolution of a Glaucoma Fellow's Surgical Training: Improvements in Tube Shunt Case Times during the Academic Year

Robbins

Aldaas

Asrani

et al. 2021

Journal of Academic Ophthalmology

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Purpose The aim of the study is to report changes in tube shunt placement surgical case times for glaucoma fellows during the course of the academic year. Patients and Methods Electronic health records were retrospectively reviewed to determine patient demographics, surgical case times (defined as procedure start time to procedure end time), and glaucoma fellow involvement. Only cases with a glaucoma fellow as the primary surgeon were included. Operative case times were compared by first and second halves of the academic year (beginning in July and ending in June) using a two-tailed t-test. Results Five hundred and seventy-three individual tube shunt surgeries (385 Ahmed, 188 Baerveldt) performed by 28 glaucoma fellows (17 females, 11 males) at Duke University Eye Center and University of North Carolina Medical Center were included. Overall, case times were significantly shorter in the second half of the academic year as compared with the first (55.3 ± 17.1 minutes vs. 61.0 ± 17.4 minutes, p <0.001). Both male (57.3 ± 16.8 minutes vs. 63.2 ± 18.6 minutes, p = 0.008) and female (53.5 ± 17.3 minutes vs. 59.3 ± 16.4 minutes, p = 0.003) fellows demonstrated shorter case times over the academic year; additionally, female fellows trended toward shorter case times than male fellows in both the first half (p = 0.072) and second half (p = 0.053) of the academic year. Fellows also exhibited shorter case times with both Ahmed implants (54.1 ± 16.2 minutes vs. 59.3 ± 15.8 minutes, p = 0.002) and Baerveldt implants (57.8 ± 18.9 minutes vs. 64.2 ± 20.0 minutes, p = 0.025) cases over the academic year. Baerveldt case times were significantly longer than Ahmed cases in the first half (p = 0.028) and trended toward being longer than Ahmed cases in the second half (p = 0.070). Conclusion Across 5 years at two academic institutions, glaucoma fellows had shorter primary tube shunt surgical case times in the second half of the academic year. These findings reflect improvement in surgical efficiency throughout glaucoma fellowship. These findings should be taken into consideration when scheduling trainee surgeries at academic medical centers at different points in the academic year.

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Ophthalmology Residency in the United States: The Case for a National Curriculum

Bhullar

Venkateswaran

2023

Seminars in Ophthalmology

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Improved utilization of operating room time for trainee cataract surgery in a public hospital setting

Cited by 7 publications

References 5 publications

<p>Efficiency of Operating Room Processes for Elective Cataract Surgeries Done by Residents in a National University Hospital</p>

<p>Efficiency of Operating Room Processes for Elective Cataract Surgeries Done by Residents in a National University Hospital</p>

Evolution of a Glaucoma Fellow's Surgical Training: Improvements in Tube Shunt Case Times during the Academic Year

Ophthalmology Residency in the United States: The Case for a National Curriculum

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