Caseload is increased by resequencing cases before and on the day of surgery at ambulatory surgery centers where initial patient recovery is in operating rooms and cleanup times are longer than typical
| Autor: | Stefanos A. Zenios, Zhengli Wang, Franklin Dexter |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Operating Rooms
medicine.medical_specialty Coronavirus disease 2019 (COVID-19) Personnel Staffing and Scheduling Efficiency Ambulatory Care Facilities Asymptomatic Article Appointments and Schedules 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology Humans Outpatient clinic Medicine Infection control Computer Simulation 030212 general & internal medicine Pandemics Decontamination Environmental Restoration and Remediation Aerosols Infection Control business.industry COVID-19 Surgery Anesthesiology and Pain Medicine Standard error Ambulatory Surgical Procedures Sample size determination Initial phase Ambulatory medicine.symptom business |
| Zdroj: | Journal of Clinical Anesthesia |
| ISSN: | 0952-8180 |
| Popis: | Study objective The coronavirus disease 2019 (COVID-19) pandemic impacts operating room (OR) management in regions with high prevalence (e.g., >1.0% of asymptomatic patients testing positive). Cases with aerosol producing procedures are isolated to a few ORs, initial phase I recovery of those patients is in the ORs, and multimodal environmental decontamination applied. We quantified the potential increase in productivity from also resequencing these cases among those 2 or 3 ORs. Design Computer simulation provided sample sizes requiring >100 years experimentally. Resequencing was limited to changes in the start times of surgeons' lists of cases. Setting Ambulatory surgery center or hospital outpatient department. Main results With case resequencing applied before and on the day of surgery, there were 5.6% and 5.5% more cases per OR per day for the 2 ORs and 3 ORs, respectively, both standard errors (SE) 90% probability of each OR finishing within the prespecified 12-h shift. Thus, the additional cases were all scheduled before the day of surgery. The greater allocated time also resulted in less overutilized time, a mean of 4.2 min per OR per day for 2 ORs (SE 0.5) and 6.3 min per OR per day for 3 ORs (SE 0.4). The benefit could be achieved while limiting application of resequencing to days when the OR with the fewest estimated hours of cases has ≤8 h. Conclusions Some ambulatory surgery ORs have unusually long OR times and/or room cleanup times (e.g., infection control efforts because of the pandemic). Resequencing cases before and on the day of surgery should be considered, because moving 1 or 2 cases occasionally has little to no cost with substantive benefit. Highlights • COVID-19 influences management for aerosol producing procedures. • Simulation studied case resequencing applied before and on the day of surgery. • >5% more queued cases can be done per OR per day with practical heuristic. |
| Databáze: | OpenAIRE |
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