Reducing Operating Room Turnover Time for Robotic Surgery Using a Motor Racing Pit Stop Model.
Reducing Operating Room Turnover Time for Robotic Surgery Using a Motor Racing Pit Stop Model.
复制标题
DOI：
10.1007/s00268-017-3936-4
复制
发表时间：
2017-08
影响因子：
2.6
通讯作者：
Anger JT
中科院分区：
文献类型：
--
作者：
Souders CP;Catchpole KR;Wood LN;Solnik JM;Avenido RM;Strauss PL;Eilber KS;Anger JT
手术室周转时间，即一名患者离开手术室到下一次进入手术室之间所花费的时间，是手术室利用率的重要决定因素，对于医院管理人员来说，这是一个关键的价值衡量标准。外科机器人增加了OR周转过程中所需任务的复杂性和数量，导致OR周转时间高度可变。我们试图简化人员周转流程，减少机器人或人员周转时间，并提高效率。对45例介入前机器人或失误进行了直接观察。按照以前成功的移交模式，我们采用了赛车维修站的概念，包括简报、领导力、角色定义、任务分配和任务排序。编制了工作人员更替任务卡，并为每次更替分发了卡片分配。干预后观察41例。平均总OR周转时间干预前为99.2min(95%可信区间88.0~110.3)，干预后3个月为53.2min(95%可信区间48.0~58.5)。从患者离开手术室到外科技术人员准备接受下一位患者的平均房间准备时间在干预前为42.2min(95%可信区间36.7~47.7)，在干预后3个月降至27.2min(95%可信区间24.7~29.7)(p<；0.0001)。角色定义、任务分配和排序，与易于使用的视觉提示相结合，创建了高效、低资源、可持续的方法，以减少机器人或周转时间。为了利用这一结果，需要进行更广泛的制度改革。维修站和其他高风险行业模式可能会为管理任务和团队的方法提供参考。
Operating room (OR) turnover time, time taken between one patient leaving the OR and the next entering, is an important determinant of OR utilization, a key value metric for hospital administrators. Surgical robots have increased the complexity and number of tasks required during an OR turnover, resulting in highly variable OR turnover times. We sought to streamline the turnover process and decrease robotic OR turnover times and increase efficiency. Direct observation of 45 pre-intervention robotic OR turnovers was performed. Following a previously successful model for handoffs, we employed concepts from motor racing pit-stops, including briefings, leadership, role definition, task allocation, and task sequencing. Turnover task cards for staff were developed and card assignments were distributed for each turnover. Forty-one cases were observed post intervention. Average total OR turnover time was 99.2 minutes (95%CI 88.0-110.3) pre- intervention and 53.2 minutes (95%CI 48.0-58.5) at three months post intervention. Average room ready time from when the patient exited the OR until the surgical technician was ready to receive the next patient was 42.2 minutes (95%CI 36.7-47.7) before the intervention, which reduced to 27.2 minutes at three months (95% CI 24.7-29.7) post intervention (p<0.0001). Role definition, task allocation and sequencing, combined with a visual cue for ease-of-use, create efficient, low resource, sustainable approaches to decreasing robotic OR turnover times. Broader system changes are needed to capitalize on that result. Pit stop and other high-risk industry models may inform approaches to the management of tasks and teams.
登录
查看更多内容
影响因子：
7.2
作者：
Anger, Jennifer T.;Mueller, Elizabeth R.;Kenton, Kimberly
通讯作者：
Kenton, Kimberly
影响因子：
5.7
作者：
Tyler, DC;Pasquariello, CA;Chen, CH
通讯作者：
Chen, CH
影响因子：
0.3
作者：
Urrego, Hernan;Sanni, Aliu;Patel, Ankit D.
通讯作者：
Patel, Ankit D.
影响因子：
1.7
作者：
Catchpole, Ken R.;De Leval, Marc R.;Goldman, Allan J.
通讯作者：
Goldman, Allan J.
影响因子：
2.7
作者：
Rebuck, David A.;Zhao, Lee C.;Nadler, Robert B.
通讯作者：
Nadler, Robert B.