Reducing otolaryngology surgical inefficiency via assessment of tray redundancy
Reducing otolaryngology surgical inefficiency via assessment of tray redundancy
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DOI：
10.1186/s40463-014-0046-2
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发表时间：
2014-12-03
影响因子：
3.4
通讯作者：
Rotenberg, Brian W.
中科院分区：
文献类型：
--
作者：
Chin, Christopher J.;Sowerby, Leigh J.;Rotenberg, Brian W.
背景：加拿大的医疗保健费用继续上升。由于医疗保健支出的不断增加，人们不断寻求提高效率和降低成本的方法。手术治疗是耳鼻咽喉头颈外科领域许多疾病的主要治疗方法。有证据表明，作为提高手术室吞吐量的新方法，存在优化托盘效率的空间。方法：我们对2013年7月5日至2013年9月20日期间在圣约瑟夫医院进行的5种常用手术的手术托盘上的仪器进行了审查。计算仪器利用率;然后我们根据至少20%的时间使用的仪器设计新的“优化”托盘。我们从中央处理部门获得托盘构建时间，然后计算每台仪器的总体平均时间（包装新清洗的仪器）。然后我们确定了使用我们新的优化托盘可以节省的时间。结果：总共观察到226个仪器托盘（表1）。平均仪器利用率为27.8%（+/- 13.1）。我们优化的托盘平均可将托盘尺寸减少57%。包装一台仪器的平均时间为17.7秒。结论：通过选择性地减少托盘，我们计划将托盘内容平均减少57%。重要的是要记住，这个数字只涉及耳鼻咽喉-头颈外科的5个手术。如果这一做法在全市范围内推广到其他部门，效率的提高可能会相当可观。
Background: Health care costs in Canada continue to rise. As a result of this relentless increase in healthcare spending, ways to increase efficiency and decrease cost are constantly being sought. Surgical treatment is the mainstay of therapy for many conditions in the field of Otolaryngology-Head and Neck Surgery. The evidence suggests that room exists to optimize tray efficiency as a novel means of improving operating room throughput.Methods: We conducted a review of instruments on surgical trays for 5 commonly performed procedures between July 5th, 2013 and September 20th, 2013 at St Joseph's Hospital. The Instrument Utilization Rate was calculated; we then designed new 'optimized' trays based on which instruments were used at least 20% of the time. We obtained tray building times from Central Processing Department, then calculated an overall mean time per instrument (to pack the freshly washed instruments). We then determined the time that could be saved by using our new optimized trays.Results: In total, 226 instrument trays were observed (Table 1). The average Instrument Utilization Rate was 27.8% (+/- 13.1). Our optimized trays, on average, reduced tray size by 57%. The average time to pack one instrument was 17.7 seconds.Conclusions: By selectively reducing our trays, we plan to reduce tray content by an average of 57%. It is important to remember that this number looks at only 5 procedures in the Department of Otolaryngology- Head and Neck Surgery. If this was expanded city-wide to the rest of the departments, the improved efficiency could potentially be quite substantial.