Improving operating room productivity via parallel anesthesia processing

Brown, Michael J.; Subramanian, Arun; Curry, Timothy B.; Kor, Daryl J.; Moran, Steven L.; Rohleder, Thomas R.

doi:10.1108/ijhcqa-11-2013-0129

Cited by 25 publications

(23 citation statements)

References 23 publications

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“…Similarly, surgeons who incentivized OR staff, such as providing lunch 21 also observed shorter turnovers Attending, effective communication and team work are vital to improving OR efficiency In our study anticipating and preparing for succeeding case during preceding surgery helped to improve turnover time as suggested in studies by Cendán & Good. 22 Surgeries preceded by an emergency surgery, also typically score badly.…”

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confidence: 48%

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Reasons for delay in turnover time in operating room- an observational study

Kumar¹,

Malhotra²

2017

Bangladesh J Med Sci

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Background: Operating room (OR) like casualty room is the most productive area of a hospital. Turnover time although is a non-productive time in the operating room, yet it is important. Its efficient utilisation require multidisciplinary team work especially supporting services which play a major role in reducing turnover time in the operating room. Since present medical college where study was being conducted is still in its evolving stage, it was considered desirable for its quality improvement to study various factors which are contributing in turnover time delay so that appropriate measures can be taken to prevent the undue turnover time delay. Materials and methods: Present prospective observational case study aims at measurement of turnover time delays during 100 working days which were completed over four months for two operation theatres. The variable chosen was the delay of turnover time from the benchmark time taken. The data were collected, compiled and analysed. Results: In orthopaedics OR 77% of turnovers were found within benchmark limits. Only in 23% cases turnovers were delayed. 47% of times hospital related issues were responsible. In surgery OR 79% of turnovers were within benchmark limits. 21% cases were delayed; of this hospital related problems caused delayed turnovers in 53% cases. Conclusions: The study concluded that reasons for delays centred on multifactorial reasons which were unavoidable and unpredictable. But if those problems that can be easily fixed are attended to, valuable time can be saved, which will ultimately keep the surgeries on schedule and will prevent cancellation of elective cases. The utilization of OT complex can be optimized by team effort, multitasking and parallel processing.

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confidence: 48%

“…20 Short preoperative briefings decrease the frequency of communication breakdowns. 20 Turnover time, is influenced by patient comorbidities (ASA class), preceding surgery, succeeding surgery, time of surgery, and order of OR cases 21 . ASA Class 1 and Class 2 patients had significantly shorter turnover times than ASA Class 3 patients 21 .…”

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confidence: 99%

Reasons for delay in turnover time in operating room- an observational study

Kumar¹,

Malhotra²

2017

Bangladesh J Med Sci

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“…9 These include the utilization of block rooms for regional anesthesia administration, dedicated orthopedic teams, parallel processing, availability of senior anesthesia staff, adequate preoperative/postoperative staffing, adequate environmental staff, and changing the infrastructure of the OR suites. 4 Other factors that affect turnover time include variables outside the OR such as equipment failure/ sterilization and patient factors. Prior studies have also suggested that surgeon delays such as inability to find the surgeon, inadequate paperwork, or improper marking of the patient was responsible for significant operative delays.…”

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confidence: 99%

Factors Affecting Hand Surgeon Operating Room Turnover Time

Gottschalk

Hinds

Muppavarapu

et al. 2016

Hand (New York, N,Y.)

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Background: The purpose of this study was to determine the factors that affect hand surgeon operating room (OR) turnover time. We hypothesized that surgeon presence in the OR, decreased American Society of Anesthesiologists (ASA) class, smaller case type, and earlier case time, as well as other factors, decreased OR turnover time. Methods: A total of 685 hand surgery cases performed by 5 attending hand surgeons between September 2013 and December 2014 were identified. Turnover time, patient comorbidities (ASA class), surgeon, prior OR surgical procedure, current OR surgical procedure, location of the surgery (ambulatory surgical center [ASC] vs orthopedic specialty hospital [OSH]), time of surgery, and order of OR cases were recorded. The effect of surgeon routine variables, OR case factors, and patient health status on OR turnover was analyzed. Results: Turnover time was significantly shorter in cases where the surgeon remained in the OR during turnover (27.5 minutes vs 30.4 minutes) and when the surgeon incentivized OR staff (24 minutes vs 29 minutes). The ASC was found to have shorter turnover times than the OSH (27.9 minutes vs 36.4 minutes). In addition, ASA class, type of prior OR procedure, type of current OR procedure, and case order all significantly affected turnover time. Comparison of OR turnover time among the 5 surgeons revealed a statistically significant difference at the OSH but not at the ASC. Conclusion: OR turnover time is significantly affected by surgeon routine, location of surgery, patient ASA class, procedure type, and case order. Interestingly, the effect of hand surgeon routine on OR turnover time may be amplified at an academic OSH versus an ASC.

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“…1 OS offers potential benefits to the overall healthcare system in the form of increased patient access to specialized care, time-and cost-effectiveness of surgical care, and opportunities for trainee independence. [2][3][4][5][6] Despite these benefits, the absence of a patient's chosen attending surgeon is likely highly meaningful to patients, 7,8 and patients may also not be comfortable with trainees performing portions of the procedure. [8][9][10][11][12] These two distinct but potentially related concerns come together in the practice of OS; however, little is known about patient perceptions of this practice.…”

Section: Introductionmentioning

confidence: 99%

Patient opinions regarding surgeon presence, trainee participation, and overlapping surgery

et al. 2018

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Objectives To explore patient opinions and underlying values regarding overlapping surgery (OS) scenarios, specifically evaluating the effect of attending surgeon presence and availability, as well as trainee participation on patient comfort level and willingness to consent. Study Design Mixed methods. Methods Forty adults participated in semi‐structured interviews. Interviews included vignettes involving three scenarios of OS (1: attending present; 2: attending absent for wound closure; 3: attending absent and unavailable for wound closure, with covering attending), visual analog scale ratings of participants’ comfort with scenarios, and cognitive debriefing. Themes and subthemes were identified using hierarchical coding of transcripts, and quantitative and qualitative analyses were conducted. Results Quantitative analysis revealed anticipated decreases in comfort with decreasing attending presence/availability (mean comfort level 94% vs. 78% vs. 63% for scenarios 1 vs. 2 vs. 3, P < 0.005), although many patients reported improved comfort with scenario 3 if meeting the covering attending. Participants demonstrated a preference for less trainee involvement (P < 0.005, scenario 1) and greater trainee experience (P < 0.05, all scenarios). However, not all individuals were uncomfortable with attending absence or trainee independence. Themes important for decision making included trust in the surgeon, surgeon experience, trainee involvement, disease severity, cost, and wait time. Conclusion Patients varied highly in their willingness to consent to OS scenarios. In settings of trainee independence and covering surgeons, many patients desired meeting these members of the treatment team, which improved comfort for some. For some patients, tradeoffs and incentives of timeliness, cost, and convenience modified their willingness to have OS. Level of Evidence 4 Laryngoscope, 129:1337–1346, 2019

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Improving operating room productivity via parallel anesthesia processing

Abstract: Simulation modeling can be an effective tool to show practice change effects at a system-wide level.

Cited by 25 publications

References 23 publications

Reasons for delay in turnover time in operating room- an observational study

Reasons for delay in turnover time in operating room- an observational study

Factors Affecting Hand Surgeon Operating Room Turnover Time

Patient opinions regarding surgeon presence, trainee participation, and overlapping surgery

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