Prozessmanagement in der Chirurgie

Kahlert, Christoph; Janda, Matthias; Weitz, J.

doi:10.1007/s00104-020-01343-z

Cited by 4 publications

(1 citation statement)

References 12 publications

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“…the OR's daily planning, the punctuality of the individual actuators, the organization between the procedures (OR preparation, patient preparation, setup, etc. ), distractions during the procedure, and the collaboration of the OR team [ 9 , 10 , 14 , 16 , 18 – 22 ]. Perioperative processes are highly complex, intertwined with significant influence on each other, and have important implications on related clinical processes, patient outcome, and safety.…”

Section: Introductionmentioning

confidence: 99%

A comparison between a maximum care university hospital and an outpatient clinic – potential for optimization in arthroscopic workflows?

Schenk,

Neumann,

Adler

et al. 2023

BMC Health Serv Res

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Background Due to the growing economic pressure, there is an increasing interest in the optimization of operational processes within surgical operating rooms (ORs). Surgical departments are frequently dealing with limited resources, complex processes with unexpected events as well as constantly changing conditions. In order to use available resources efficiently, existing workflows and processes have to be analyzed and optimized continuously. Structural and procedural changes without prior data-driven analyses may impair the performance of the OR team and the overall efficiency of the department. The aim of this study is to develop an adaptable software toolset for surgical workflow analysis and perioperative process optimization in arthroscopic surgery. Methods In this study, the perioperative processes of arthroscopic interventions have been recorded and analyzed subsequently. A total of 53 arthroscopic operations were recorded at a maximum care university hospital (UH) and 66 arthroscopic operations were acquired at a special outpatient clinic (OC). The recording includes regular perioperative processes (i.a. patient positioning, skin incision, application of wound dressing) and disruptive influences on these processes (e.g. telephone calls, missing or defective instruments, etc.). For this purpose, a software tool was developed (‘s.w.an Suite Arthroscopic toolset’). Based on the data obtained, the processes of the maximum care provider and the special outpatient clinic have been analyzed in terms of performance measures (e.g. Closure-To-Incision-Time), efficiency (e.g. activity duration, OR resource utilization) as well as intra-process disturbances and then compared to one another. Results Despite many similar processes, the results revealed considerable differences in performance indices. The OC required significantly less time than UH for surgical preoperative (UH: 30:47 min, OC: 26:01 min) and postoperative phase (UH: 15:04 min, OC: 9:56 min) as well as changeover time (UH: 32:33 min, OC: 6:02 min). In addition, these phases result in the Closure-to-Incision-Time, which lasted longer at the UH (UH: 80:01 min, OC: 41:12 min). Conclusion The perioperative process organization, team collaboration, and the avoidance of disruptive factors had a considerable influence on the progress of the surgeries. Furthermore, differences in terms of staffing and spatial capacities could be identified. Based on the acquired process data (such as the duration for different surgical steps or the number of interfering events) and the comparison of different arthroscopic departments, approaches for perioperative process optimization to decrease the time of work steps and reduce disruptive influences were identified.

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Section: Introductionmentioning

confidence: 99%

A comparison between a maximum care university hospital and an outpatient clinic – potential for optimization in arthroscopic workflows?

Schenk,

Neumann,

Adler

et al. 2023

BMC Health Serv Res

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Safe Transition from Open to Total Minimally Invasive Esophagectomy for Cancer Utilizing Process Management Methodology

Bjelovic,

Gunjic,

Babic

et al. 2024

JCM

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Background: The global shift from open esophagectomy (OE) to minimally invasive esophagectomy (MIE) for treating esophageal cancer is well-established. Recent data indicate that transitioning from hybrid minimally invasive esophagectomy (hMIE) to total minimally invasive esophagectomy (tMIE) can be challenging due to concerns about higher leakage rates and lower lymph node counts, especially at the beginning of the learning curve. This study aimed to demonstrate that a safe transition from OE to tMIE for cancer is possible using process management methodology. Methods: A step-change approach was adopted in process management planning, with hMIE serving as an intermediate step between OE and tMIE. This single-center, case–control study included 150 patients who underwent the Ivor Lewis procedure with curative intent for esophageal cancer. Among these patients, 50 underwent OE, 50 hMIE (laparoscopic procedure followed by conventional right thoracotomy), and 50 tMIE (laparoscopic and thoracoscopic approach). A preceptored training scheme was implemented during execution, and treatment results were monitored and controlled to ensure a safe transition. Results: During the transition, the tMIE group was not worse than the hMIE and OE groups regarding operation duration (p = 0.135), overall postoperative complications (p = 0.020), anastomotic leakage rates (p = 0.773), 30-day mortality (p = 1.0), and oncological outcomes (based on R status (p = 0.628) and 2-year survival (p = 0.967)). Additionally, the tMIE group showed superior results in terms of major postoperative pulmonary complications (p = 0.004) and ICU stay duration (p < 0.001). Conclusions: Utilizing managerial methodology and practice in surgery, as a bridge between interdisciplinary and transdisciplinary approaches, demonstrated that transitioning from OE to tMIE, with hMIE as an intermediate step, is safe and feasible without compromising outcomes.

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Estresse, satisfação e motivação da enfermagem do bloco operatório no Brasil

Oliveira,

Gomes,

Silva

et al. 2025

Acta paul. enferm.

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Resumo Objetivo Avaliar o estresse laboral, a satisfação e a motivação para o trabalho de profissionais de enfermagem de bloco operatório no Brasil. Métodos Estudo do tipo open survey nacional, realizado entre os meses de agosto e dezembro de 2023. Utilizou-se Escala de Satisfação no Trabalho - EST, o questionário de Motivação para o trabalho e a Escala de Estresse no Trabalho – EET em um formulário online. Resultados Houve um total de 385 respostas, sendo 160 profissionais (41,6%) técnicos ou auxiliares de enfermagem e 225(58,4%) enfermeiros. Houve elevada parcela de profissionais com níveis de estresse entre moderado e elevado (72,98%), tendo sido significativo o resultado de maior estresse moderado a elevado nos profissionais do turno diurno (p=0,01) e sem diferença por gênero nem faixa etária. Não houve diferença estatisticamente significativa entre as variáveis para técnicos e enfermeiros, nem em função do tipo de vínculo. Ter dois ou mais empregos e trabalhar em horários diurnos está associado a maior percepção de estresse relacionado ao trabalho. Conclusão A elevada proporção de profissionais técnicos de enfermagem e enfermeiros com estresse moderado e elevado merece destaque entre os achados da pesquisa.

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Prozessmanagement in der Chirurgie

Cited by 4 publications

References 12 publications

A comparison between a maximum care university hospital and an outpatient clinic – potential for optimization in arthroscopic workflows?

A comparison between a maximum care university hospital and an outpatient clinic – potential for optimization in arthroscopic workflows?

Safe Transition from Open to Total Minimally Invasive Esophagectomy for Cancer Utilizing Process Management Methodology

Estresse, satisfação e motivação da enfermagem do bloco operatório no Brasil

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