Surgical team turnover and operative time: An evaluation of operating room efficiency during pulmonary resection

Azzi, Alain J.; Shah, Karan S.; Seely, Andrew J. E.; Villeneuve, James; Sundaresan, Sudhir; Shamji, Farid M.; Maziak, Donna E.; Gilbert, Sébastien

doi:10.1016/j.jtcvs.2015.12.040

Cited by 26 publications

(16 citation statements)

References 15 publications

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“…Reductions in this have knock-on effects of reduced waiting lists and reduced cost per operation. Furthermore, it has been linked to lower risk of perioperative adverse events and improved patient satisfaction 12. It is shown that longer operative times correlate with increased risk of complications and longer postoperative recovery 13.…”

Section: Barriers To An Effective Teammentioning

confidence: 99%

Surgical team: improving teamwork, a review

Kumar

Morad

Sonsati

2019

Postgraduate Medical Journal

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Teams within surgery have been through countless cycles of refinement with an ever-increasing list of surgical team members. This results in a more dispersed team, making effective teamwork harder to achieve. Furthermore, the ad hoc nature of surgical teams means that team familiarity is not always given. The impact of this is seen across the field, with inadequacies leading to disastrous outcomes. This is a review of research that has been done into the topic of surgical teams. It will investigate barriers and consider the evidence available on how to improve the current system. Studies show an increased effectiveness of surgical teams with structures that allowed consistency in team members. The research advocates that advancements made in improving teamwork and efficiency can prove to be a low-cost but high-yield strategy for development. This can be in terms of simulated training, staff turnover management and fixed team allocation.

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Section: Barriers To An Effective Teammentioning

confidence: 99%

Surgical team: improving teamwork, a review

Kumar

Morad

Sonsati

2019

Postgraduate Medical Journal

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“…Several studies have shown that the experience and distinctive character of the individual surgeon or the surgical team in uences the duration of the operative duration [14,15,16]. The current studies illustrate that Operative duration is longer in the presence of junior surgical trainees, which may re ect both the procedural learning curve as well as potential confounding due to referral of complex surgical cases to senior attending supervision.…”

Section: Discussionmentioning

confidence: 57%

The risk factors related to operative duration and its relationship with clinical outcome in pediatric patients undergone Roux-en-Y hepaticojejunostomy

Gao

Liu

et al. 2020

Preprint

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Background: The operative duration might be important for perioperative morbidity and the involvement has not been fully characterized in pediatric patients. We here determined the perioperative variables in association with operative duration and its influence on the clinical outcome in the pediatric patients.Methods: We retrospectively reviewed 701 patients who underwent elective choledochal cysts followed by Roux-en-Y hepaticojejunostomy between August 2010 and Aug 2019. Based on the median operating time (165 min), patients were separated into two groups, including a long-time group (>165 min) and a short-time group (<165 min). The independent risk factors for the operative time were determined usng the multivariable logistic regression analyses. To adjust for any potential selection bios, propensity score matching was performed for the long-time and short-time groups. In the 192 matched patients, perioperative outcomes, including postoperative recovery, complications measurement, and length of hospital stay were analyzed.Results: The operating time was often increased by excision difficulty caused by the lager choledochal cyst size (OR=1.56; 95% CI, 1.09-2.23; p<0.001), the greater BMI(OR=1.02; 95% CI, 1.00-1.15; p=0.018), older age (OR=1.17; 95% CI, 1.02-1.39; p=0.012) under multivariate analysis. The long-time surgical duration was associated with delay for gastrointestinal functional recovery, measured with the first defecation (p=0.027) and first bowel movement (p=0.019). Moreover, a significant decrease in serum albumin were presented in the long-time group compared with the short time group (p=0.0035). The total length of postoperative hospital stay was longer in patients with long-time group (7.51±2.03 days) than patients with short-time group (6.72±1.54 days, p = 0.006).Conclusions: Our data demonstrated that short operating time was associated with favorable postoperative results. The influencing factors for operating time could be ameliorated in the perioperative period to gain a better outcome after major abdominal operations.

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“…Many factors affected the turnover time including an inefficient central processing of instruments or a multidisciplinary problem involving nursing, anesthesia, housekeeping and the turnover team staff not working in co-ordination [9]. Active management of surgical team turnover may be an opportunity to improve operating room efficiency [10]. In our study, an instructional supervision program by an operating room assistant was conducted to significantly reduce turnover time.…”

Section: Discussionmentioning

confidence: 98%

Implementing Instructional Supervision by an Operating Room Assistant to Reduce Turnover Time

Pan

Zhou

et al. 2018

BJSTR

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Background: Turnover time is still not negligible in ensuring efficient operating room(OR) management. A prospective study was performed to evaluate the effect of instructional supervision by an OR assistant on reducing turnover time. Material and Methods:We prospectively included surgical cases undergoing turnover operation after the first case from two ORs in a single center between Mar 2015 and Feb 2016. Cases in one OR received the instructional supervision by an OR assistant. Cases in another OR received not. The primary endpoint was the percentage of surgical case with turnover time ≤ 45min. Other endpoints were turnover time, the percentage of the teamwork score of OR staffs ≥4 point and the percentage of patient satisfaction score≥4 point.Results: Over 48 weeks, the effect of instructional supervision was evaluated in 1826 surgical cases undergoing turnover operation. Compared with those in the non-intervention group(n=904), the percentage of surgical cases with turnover time ≤ 45min decreased significantly (80.4% VS 59.6%, P<0.001) in the instructional supervision group(n=922). In the instructional supervision group, there was a significant improvement in turnover time (49.6min VS 37.9min; P<0.001), the percentage of the teamwork score≥4 point (84.8% VS 79.4%; P=0.003) and the percentage of patient satisfaction score≥4 point (89.7% VS 78.1%, P<0.001). Conclusion:Implementing instructional supervision by an OR assistant can potentially reduce our OR turnover time.

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Surgical team turnover and operative time: An evaluation of operating room efficiency during pulmonary resection

Abstract: Active management of surgical team turnover may be an opportunity to improve operating room efficiency when the surgical team is engaged in a major pulmonary resection.

Cited by 26 publications

References 15 publications

Surgical team: improving teamwork, a review

Surgical team: improving teamwork, a review

The risk factors related to operative duration and its relationship with clinical outcome in pediatric patients undergone Roux-en-Y hepaticojejunostomy

Implementing Instructional Supervision by an Operating Room Assistant to Reduce Turnover Time

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