Prospective Evaluation of Operating Room Inefficiency
| Autor: | Luis R. Taveras, Holly B. Cunningham, Steven E. Wolf, Herbert Phelan, Audra T. Clark, Tarik D. Madni, Jonathan B. Imran, Brett D. Arnoldo |
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| Rok vydání: | 2018 |
| Předmět: |
Operating Rooms
medicine.medical_specialty Burn Units Operative Time Video Recording Efficiency Organizational Prospective evaluation 03 medical and health sciences 0302 clinical medicine Cost Savings medicine Humans End of induction Prospective Studies Video recording Live video business.industry Rehabilitation 030208 emergency & critical care medicine Quality Improvement Cost savings Surgery Turnover time 030220 oncology & carcinogenesis Emergency Medicine Operative time Burns business |
| Zdroj: | Journal of Burn Care & Research. 39:977-981 |
| ISSN: | 1559-0488 1559-047X |
| DOI: | 10.1093/jbcr/iry016 |
| Popis: | Previously, they identified that 60 per cent of their facility's total operative time is nonoperative. They performed a review of their operating room to determine where inefficiencies exist in nonoperative time. Live video of operations performed in a burn operating room from June 23, 2017 to August 16, 2017 was prospectively reviewed. Preparation (end of induction to procedure start) and turnover (patient out of room to next patient in room) were divided into the following activities: 1) Preparation: remove dressing, position patient, clean patient, drape patient, and 2) Turnover: clean operating room, scrub tray setup, anesthesia setup. Ideal preparation time was calculated as the sum of time needed to perform preparation activities consecutively. Ideal turnover time was calculated as the sum of time needed to clean the operating room and to set up either the scrub tray or anesthesia (the larger of the two times as these can be done in parallel). They reviewed 101 consecutive operations. An average of 2.4 ± 0.8 cases per day were performed. Ideal preparation and turnover time were 16.6 and 30.1 minutes, a 38.3 and 32.5 per cent reduction compared with actual times. Attending surgeon presence in the operating room within 10 minutes of a patient's arrival was found to significantly decrease time to incision by 33 per cent (52.7 ± 14.3 minutes down to 35.7 ± 20.4, P < .0001). A reduction in preparation and turnover time could save $1.02 million and generate $1.76 million in additional revenue annually. Reducing preparation and turnover to ideal times could increase caseload to 4 per day, leading to millions of dollars of savings annually. |
| Databáze: | OpenAIRE |
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