Rapid Communication: Small Changes in Operative Time Can Yield Discrete Increases in Operating Room Throughput

2007 ◽  
Vol 21 (7) ◽  
pp. 703-708 ◽  
Author(s):  
Andreas R. Seim ◽  
Douglas M. Dahl ◽  
Warren S. Sandberg
Keyword(s):  
Operating Room ◽  
Operative Time ◽  
Rapid Communication

Are operating room distractions, interruptions, and disruptions associated with performance and patient safety? A systematic review and meta-analysis

2021 ◽  
Author(s):  
Ryan D McMullan ◽  
Rachel Urwin ◽  
Peter Gates ◽  
Neroli Sunderland ◽  
Johanna I Westbrook
Keyword(s):  
Patient Safety ◽  
Operating Room ◽  
Random Effects ◽  
Team Performance ◽  
Operative Time ◽  
Meta Analysis ◽  
Individual Performance ◽  
Negative Effects ◽  
Total Operative Time ◽  
Operative Duration

Abstract Background The operating room (OR) is a complex environment in which distractions, interruptions, and disruptions (DIDs) are frequent. Our aim was to synthesise research on the relationships between DIDs and (a) operative duration, (b) team performance, (c) individual performance, and (d) patient safety outcomes; in order to better understand how interventions can be designed to mitigate the negative effects of DIDs. Methods Electronic databases (MEDLINE, Embase, CINAHL, PsycINFO) and reference lists were systematically searched. Included studies were required to report quantitative outcomes of the association between DIDs and team performance, individual performance, and patient safety. Two reviewers independently screened articles for inclusion, assessed study quality, and extracted data. A random effects meta-analysis was performed on a subset of studies reporting total operative time and DIDs. Results Twenty-seven studies were identified. The majority were prospective observational studies (n=15), of moderate quality (n=15). DIDs were often defined, measured, and interpreted differently in studies. DIDs were significantly associated with: extended operative duration (n=8), impaired team performance (n=6), self-reported errors by colleagues (n=1), surgical errors (n=1), increased risk and incidence of surgical site infection (n=4), and fewer patient safety checks (n=1). A random effects meta-analysis showed that the proportion of total operative time due to DIDs was 22.0% (95% CI 15.7-29.9). Conclusion DIDs in surgery are associated with a range of negative outcomes. However, significant knowledge gaps exist about the mechanisms that underlie these relationships, as well as the potential clinical and non-clinical benefits that DIDs may deliver. Available evidence indicates that interventions to reduce the negative effects of DIDs are warranted, but current evidence is not sufficient to make recommendations about potentially useful interventions.

scholarly journals An assessment of the quality indicators of operative and non-operative times in a public university hospital

2015 ◽  
Vol 13 (4) ◽  
pp. 594-599 ◽  
Author(s):  
Altair da Silva Costa Jr ◽  
Luiz Eduardo Villaça Leão ◽  
Maykon Anderson Pires de Novais ◽  
Paola Zucchi
Keyword(s):  
Standard Deviation ◽  
Operating Room ◽  
Operative Time ◽  
Patient Flow ◽  
Cross Sectional Study ◽  
Public University ◽  
Major Effect ◽  
University Hospital ◽  
Cross Sectional ◽  
Using Data

ABSTRACT Objective To assess the operative time indicators in a public university hospital. Methods A descriptive cross-sectional study was conducted using data from operating room database. The sample was obtained from January 2011 to January 2012. The operations performed in sequence in the same operating room, between 7:00 am and 5:00 pm, elective or emergency, were included. The procedures with incomplete data in the system were excluded, as well as the operations performed after 5:00 pm or on weekends or holidays. Results We measured the operative and non-operative time of 8,420 operations. The operative time (mean and standard deviation) of anesthesias and operations were 177.6±110 and 129.8±97.1 minutes, respectively. The total time of the patient in operative room (mean and standard deviation) was 196.8±113.2. The non-operative time, e.g., between the arrival of the patient and the onset of anesthesia was 14.3±17.3 minutes. The time to set the next patient in operating room was 119.8±79.6 minutes. Our total non-operative time was 155 minutes. Conclusion Delays frequently occurred in our operating room and had a major effect on patient flow and resource utilization. The non-operative time was longer than the operative time. It is possible to increase the operating room capacity by management and training of the professionals involved. The indicators provided a tool to improve operating room efficiency.

scholarly journals Assessment of operative times of multiple surgical specialties in a public university hospital

2017 ◽  
Vol 15 (2) ◽  
pp. 200-205 ◽  
Author(s):  
Altair da Silva Costa Jr
Keyword(s):  
Operating Room ◽  
Operative Time ◽  
Cross Sectional Study ◽  
Public University ◽  
University Hospital ◽  
Cross Sectional ◽  
Mean Values ◽  
Operating Room Planning ◽  
Duration Of Surgery ◽  
The Mean

ABSTRACT Objective To evaluate the indicators duration of anesthesia, operative time and time patients stay in the operating rooms of different surgical specialties at a public university hospital. Methods It was done by a descriptive cross-sectional study based on the operating room database. The following stages were measured: duration of anesthesia, procedure time and patient length of stay in the room of the various specialties. We included surgeries carried out in sequence in the same room, between 7:00 a.m. and 5 p.m., either elective or emergency. We calculated the 80th percentile of the stages, where 80% of procedures were below this value. Results The study measured 8,337 operations of 12 surgical specialties performed within one year. The overall mean duration of anesthesia of all specialties was 178.12±110.46 minutes, and the 80th percentile was 252 minutes. The mean operative time was 130.45±97.23 minutes, and the 80th percentile was 195 minutes. The mean total time of the patient in the operating room was 197.30±113.71 minutes, and the 80th percentile was 285 minutes. Thus, the variation of the overall mean compared to the 80th percentile was 41% for anesthesia, 49% for surgeries and 44% for operating room time. In average, anesthesia took up 88% of the operating room period, and surgery, 61%. Conclusion This study identified patterns in the duration of surgery stages. The mean values of the specialties can assist with operating room planning and reduce delays.

scholarly journals Evaluation of ECHO PS Positioning System in a Porcine Model of Simulated Laparoscopic Ventral Hernia Repair

ISRN Surgery ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-8
Author(s):  
Erin M. Hanna ◽  
Guy R. Voeller ◽  
J. Scott Roth ◽  
Jeffrey R. Scott ◽  
Darcy H. Gagne ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Operating Room ◽  
Ventral Hernia Repair ◽  
Operative Time ◽  
Porcine Model ◽  
Suture Technique ◽  
Laparoscopic Ventral Hernia Repair ◽  
Positioning System ◽  
Procedure Time

Purpose. Operative efficiency improvements for laparoscopic ventral hernia repair (LVHR) have focused on reducing operative time while maintaining overall repair efficacy. Our objective was to evaluate procedure time and positioning accuracy of an inflatable mesh positioning device (Echo PS Positioning System), as compared to a standard transfascial suture technique, using a porcine model of simulated LVHR. Methods. The study population consisted of seventeen general surgeons (n=17) that performed simulated LVHR on seventeen (n=17) female Yorkshire pigs using two implantation techniques: (1) Ventralight ST Mesh + Echo PS Positioning System (Echo PS) and (2) Ventralight ST Mesh + transfascial sutures (TSs). Procedure time and mesh centering accuracy overtop of a simulated surgical defect were evaluated. Results. Echo PS demonstrated a 38.9% reduction in the overall procedure time, as compared to TS. During mesh preparation and positioning, Echo PS demonstrated a 60.5% reduction in procedure time (P<0.0001). Although a trend toward improved centering accuracy was observed for Echo PS (16.2%), this was not significantly different than TS. Conclusions. Echo PS demonstrated a significant reduction in overall simulated LVHR procedure time, particularly during mesh preparation/positioning. These operative time savings may translate into reduced operating room costs and improved surgeon/operating room efficiency.

Use of intraoperative digital specimen mammography to improve operative efficiency.

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 138-138
Author(s):  
M. Valero ◽  
L. S. Dominici ◽  
M. Golshan
Keyword(s):  
Operating Room ◽  
Operative Time ◽  
Breast Biopsy ◽  
Excisional Biopsy ◽  
Academic Center ◽  
Downstream Effects ◽  
Record Review ◽  
Surgical Oncologist ◽  
Lymph Node Evaluation ◽  
Median Operative Time

138 Background: The traditional method of confirming excision of a targeted lesion during wire localized breast biopsy has been with standard specimen mammograms (SSM). More recently, intraoperative digital specimen mammograms (IDSM) have been used to provide immediate specimen evaluation for the surgeon in the operating room. We sought to evaluate operative time with the use of IDSM versus SSM. Methods: A retrospective chart and electronic operating room record review of consecutive patients of a single breast surgical oncologist at a quaternary care academic center. Three hundred and forty-four (344) consecutive patients from 2003 to 2010 who underwent wire localized excisional biopsy or wire localized lumpectomy without lymph node evaluation, with specimen evaluation by IDSM or SSM. Operative time, defined as documented time of incision to documented time of closure, was recorded for SSM versus IDSM. Results: We compared demographics of the two groups transitioning from SSM to IDSM (Table). During the study period, median operative time decreased from 50 minutes in the SSM group to 37 minutes in the IDSM group (p<0.001). Conclusions: Operative times with the use of IDSM are significantly shorter than with SSM. Downstream effects include decreases in anesthetic time, anesthetic use, operating room charges, and increasing surgeon productivity. [Table: see text]

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

2016 ◽  
Vol 151 (5) ◽  
pp. 1391-1395 ◽  
Author(s):  
Alain Joe Azzi ◽  
Karan Shah ◽  
Andrew Seely ◽  
James Patrick Villeneuve ◽  
Sudhir R. Sundaresan ◽  
...  
Keyword(s):  
Operating Room ◽  
Operative Time ◽  
Pulmonary Resection ◽  
Surgical Team ◽  
Operating Room Efficiency

scholarly journals A Time-Motion Study on the Operating Room Processes among Pregnant COVID-19 Patients Undergoing Cesarean Section in a Tertiary Government Hospital

2021 ◽  
Vol 55 (2) ◽  
Author(s):  
Ma. Evita Dela Cruz-Tabanda ◽  
Maria Angela Bandola
Keyword(s):  
Cesarean Section ◽  
Operating Room ◽  
Operative Time ◽  
Obstetric Care ◽  
Evaluation Study ◽  
Closing Time ◽  
Time Motion ◽  
Time And Motion ◽  
Motion Study

Objective. This study aims to determine time and motion in the operating room in emergent, urgent and scheduled cesarean section surgeries among pregnant COVID-19 patients. Methodology. A time and motion performance evaluation study was done by computing the following parameters: pre-induction time, pre-incision time, opening time, closing time, for both decision-to-delivery interval (DDI) and overall operative time. Results. During the study period, emergent DDI average was 2 hours and 38 minutes, emergent overall operative time was 1 hour and 31minutes, urgent DDI average was 3 hours and 51 minutes, and urgent overall operative time of 1 hour and 57 minutes. However, in both urgent and emergent cases, the recommended DDI of 30 minutes, and the average duration of 44.3 minutes for CS were not feasible. Conclusion. The COVID-19 pandemic has negatively affected the provision of surgical obstetric care and OR utilization. Due to the new safety protocol for healthcare workers and patients, there was a significant delay in DDI and overall operative time. The causes were preparation, anesthesia factors or obstetrician factors. Identifying modifiable obstacles may improve the DDI, overall operative time, and the quality of maternal and child birth care during this pandemic.

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