Identification and classification of flow disruptions in the operating room during two types of general surgery procedures

2010 ◽  
Author(s):  
Sacha N. Duff ◽  
T. Christopher Windham ◽  
Douglas A. Wiegmann ◽  
Jason Kring ◽  
Jennifer D. Schaus ◽  
...  
Keyword(s):  
Operating Room ◽  
General Surgery ◽  
Flow Disruptions

Identification and Classification of Flow Disruptions in the Operating Room during Two Types of General Surgery Procedures

2010 ◽  
Vol 54 (12) ◽  
pp. 884-888 ◽  
Author(s):  
Sacha N. Duff ◽  
T. Christopher Windham ◽  
Douglas A. Wiegmann ◽  
Jason Kring ◽  
Jennifer D. Schaus ◽  
...  
Keyword(s):  
Operating Room ◽  
General Surgery ◽  
Flow Disruptions

scholarly journals CAN VIRTUAL REALITY BE AS GOOD AS OPERATING ROOM TRAINING? EXPERIENCE FROM A RESIDENCY PROGRAM IN GENERAL SURGERY

2018 ◽  
Vol 31 (4) ◽  
Author(s):  
Bruno Della Mea GASPERIN ◽  
Thamyres ZANIRATI ◽  
Leandro Totti Cavazzola
Keyword(s):  
Virtual Reality ◽  
Operating Room ◽  
General Surgery ◽  
Training Experience ◽  
Total Procedure Time ◽  
Significant Difference ◽  
Hands On ◽  
Second Year ◽  
Practice Time

ABSTRACT Background: The increasingly intense usage of technology applied to videosurgery and the advent of robotic platforms accelerated the use of virtual models in training surgical skills. Aim: To evaluate the performance of a general surgery department’s residents in a video-simulated laparoscopic cholecystectomy in order to understand whether training with virtual reality is sufficient to provide the skills that are normally acquired in hands-on experience at the operating room. Methods: An observational study with twenty-five first- and second-year general surgery residents. Each subject performed three video-laparoscopic cholecystectomies under supervision in a simulator. Only the best performance was evaluated in the study. Total number of complications and total procedure time were evaluated independently. The groups were defined according to total practice time (G1 and G2) and the year of residency (R1 and R2), each being analysed separately. Results: Twenty-one residents finished the three practices, with four follow-up losses. Mean practice time was 33.5 hours. Lowering of the rate of lesions in important structures could be identified after a level of proficiency of 60%, which all participants obtained regardless of previous in vivo experience. No significant difference between the R1 and R2 groups was observed. Conclusion: Learning in groups R1 and R2 was equal, regardless of whether previous practice was predominantly in vivo (R2) or with virtual reality (R1). Therefore, it is possible to consider that skills obtained in virtual reality training are capable of equalising the proficiency of first- and second-year residents, being invaluable to increase patient safety and homogenise learning of basic surgical procedures.

Classification of OPERATING ROOM MORTALITY

1960 ◽  
Vol 39 (2) ◽  
pp. 158???166 ◽  
Author(s):  
RICHARD AMENT
Keyword(s):  
Operating Room

scholarly journals The Effect of Scheduling on Operating Room Utilization at an Affiliated Hospital of Shahid Sadoughi University of Medical Sciences in Yazd

2019 ◽  
Author(s):  
Seyed Jamaledin Tabibi ◽  
Bahram Delgoshaei ◽  
Maryam Nikfard
Keyword(s):  
Operating Room ◽  
General Surgery ◽  
Cross Sectional Study ◽  
Utilization Rate ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Research Findings ◽  
Turn Over ◽  
Surgical Unit ◽  
Nose And Throat

Introduction: Resource management and efficiency analysis assist the hospitals in controlling the expenses and optimum utilization. Operating room (OR) is one of the most critical and expensive resources in a hospital. Operating room utilization is a measure calculated as a ratio between the available time and the used actual minutes. In the current study, we aimed to measure OR utilization in Yazd Shahid Sadoughi Hospital. Methods: This is a descriptive cross-sectional study in which all the surgeries performed in ORs of Shahid Sadoughi Hospital were investigated during a 15-day period. Data were collected from four randomly-selected rooms in the surgical unit in January 2013 using some pre-designed checklists. Results: A total of 151 surgeries were conducted during a 53-day period in four ORs. We found that OR utilization was 68% for the Orthopedics, 61% for the Ophthalmology, 89% for the General Surgery, and 86% for the ear, nose and throat (ENT) ORs. Total adjusted utilization was 77% and raw utilization rate was 70%. Of the 19080 minutes dedicated for surgeries, 13400 minutes were spent on surgeries and 1215 minutes were used for the turn-over-time or the delay between two surgeries. Of 53 days, the ORs were used efficiently for 7 days, under-utilized for 27 days, and over-utilizedfor 19 days. Conclusion: Data analysis showed that the Orthopedics and Ophthalmology ORs were under-utilized; whereas, the General Surgery room was over-utilized. The ENT utilization was in an appropriate range. The lowest utilization rate in a day was recorded for the Orthopedics OR (17%), while the highest rate was 158% for ENT. Further studies are recommended to measure OR utilization in a longer period of time and use the research findings to have accurate  scheduling for the ORs leading to their efficiency improvement.

scholarly journals Experiences with the standardized classification of surgical complications (Clavien-Dindo) in general surgery patients

2018 ◽  
Vol 50 (6) ◽  
pp. 256-261 ◽  
Author(s):  
M. Bolliger ◽  
J.-A. Kroehnert ◽  
F. Molineus ◽  
D. Kandioler ◽  
M. Schindl ◽  
...  
Keyword(s):  
General Surgery ◽  
Surgical Complications

Effect of the 80-Hour Work Week on Cases Performed by General Surgery Residents

2005 ◽  
Vol 71 (7) ◽  
pp. 552-556 ◽  
Author(s):  
Shannon Tierney Mcelearney ◽  
Alison R. Saalwachter ◽  
Traci L. Hedrick ◽  
Timothy L. Pruett ◽  
Hilary A. Sanfey ◽  
...  
Keyword(s):  
Medical Education ◽  
Operating Room ◽  
Graduate Medical Education ◽  
Surgical Training ◽  
General Surgery ◽  
Work Hours ◽  
University Hospital ◽  
Training Experience ◽  
Accreditation Council ◽  
Graduate Medical

The Accreditation Council for Graduate Medical Education (ACGME) implemented mandatory work week hours restrictions in 2003. Due to the traditionally long hours in general surgery, the effect of restrictions on surgical training and case numbers was a matter of concern. Data was compiled retrospectively from ACGME logs and operating room (OR) records at a university hospital for 2002 and 2003. Work week restrictions began in January 2003. This data was reviewed to determine resident case numbers, both in whole and by postgraduate year (PGY). Mean case numbers per resident-month in 2002 were 8.8 ± 8.2 for PGY1s, 16.2 ± 15.7 for PGY2s, 31.4 ± 12.9 for PGY3s, 31.5 ± 17.6 for PGY4s, and 31.5 ± 17.6 for PGY5s. In 2003, they were 8.8 ± 5.2 for PGY1s, 16.6 ± 13.9 for PGY2s, 27.8 ± 12.5 for PGY3s, 38.2 ± 18.8 for PGY4s, and 26.1 ± 9.6 for PGY5s. PGY1s, PGY2s, PGY3s, PGY4s, or all classes were not statistically different. PGY5s did have statistically fewer cases in 2003 ( P = 0.03). PGY5s did have statistically fewer cases after the work-hours restriction, which likely represented shifting of postcall afternoon cases to other residents. Comparing other classes and all PGYs, case numbers were not statistically different. Operative training experience does not appear to be hindered by the 80-hour work week.

scholarly journals Intraoperative dynamics of workflow disruptions and surgeons' technical performance failures: insights from a simulated operating room

2021 ◽  
Author(s):  
Amelie Koch ◽  
Aljoscha Kullmann ◽  
Philipp Stefan ◽  
Tobias Weinmann ◽  
Sebastian F. Baumbach ◽  
...  
Keyword(s):  
Operating Room ◽  
Mixed Reality ◽  
Binary Logistic Regression ◽  
Video Observation ◽  
Binary Logistic Regression Model ◽  
Surgical Performance ◽  
Subsequent Performance ◽  
Technical Performance ◽  
Flow Disruptions ◽  
Set Up

Abstract Introduction Flow disruptions (FD) in the operating room (OR) have been found to adversely affect the levels of stress and cognitive workload of the surgical team. It has been concluded that frequent disruptions also lead to impaired technical performance and subsequently pose a risk to patient safety. However, respective studies are scarce. We therefore aimed to determine if surgical performance failures increase after disruptive events during a complete surgical intervention. Methods We set up a mixed-reality-based OR simulation study within a full-team scenario. Eleven orthopaedic surgeons performed a vertebroplasty procedure from incision to closure. Simulations were audio- and videotaped and key surgical instrument movements were automatically tracked to determine performance failures, i.e. injury of critical tissue. Flow disruptions were identified through retrospective video observation and evaluated according to duration, severity, source, and initiation. We applied a multilevel binary logistic regression model to determine the relationship between FDs and technical performance failures. For this purpose, we compared FDs in one-minute intervals before performance failures with intervals without subsequent performance failures. Results Average simulation duration was 30:02 min (SD = 10:48 min). In 11 simulated cases, 114 flow disruption events were observed with a mean hourly rate of 20.4 (SD = 5.6) and substantial variation across FD sources. Overall, 53 performance failures were recorded. We observed no relationship between FDs and likelihood of immediate performance failures: Adjusted odds ratio = 1.03 (95% CI 0.46–2.30). Likewise, no evidence could be found for different source types of FDs. Conclusion Our study advances previous methodological approaches through the utilisation of a mixed-reality simulation environment, automated surgical performance assessments, and expert-rated observations of FD events. Our data do not support the common assumption that FDs adversely affect technical performance. Yet, future studies should focus on the determining factors, mechanisms, and dynamics underlying our findings.

Sign in / Sign up

Export Citation Format

Share Document