Elective change of surgeon during the OR day has an operationally negligible impact on turnover time.
Elective change of surgeon during the OR day has an operationally negligible impact on turnover time.
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DOI：
10.1016/j.jclinane.2014.02.008
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发表时间：
2014-08
影响因子：
6.7
通讯作者：
Sandberg, Warren S.
中科院分区：
文献类型：
--
作者：
Austin, Thomas M.;Lam, Humphrey V.;Shin, Naomi S.;Daily, Bethany J.;Dunn, Peter F.;Sandberg, Warren S.
比较一系列择期手术的周转时间，其中外科医生遵循自己的顺序，与一系列先前计划的择期手术的周转时间，其中后续外科医生与先前外科医生不同。我们还考虑了改变手术类型和一天中的时间对周转时间的影响。回顾性队列研究。大学附属教学医院。我们使用手术室统计数据库从一家大型学术机构收集了32个月的营业额数据。同一外科医生和外科医生交换组的周转时间数据按月分批，以最大限度地减少自相关并实现数据标准化。使用每月批次数据进行双因素ANOVA，外科医生交换和手术类别变化作为周转时间变量。使用个体手术服务和手术日期间的每小时时间间隔作为外科医生交换的额外协变量进行类似分析。平均（95%置信区间）同一外科医生更换时间为43.6（43.2 - 44.0）min，而计划外科医生更换时间为51.0（50.5 - 51.6）min（p < 0.0001）。这导致差异（95%置信区间）为7.4（6.8 - 8.1）min。周转时间的确切增加取决于手术服务、后续手术类型的变化、发生周转的时间和每个OR的周转频率。被调查的机构平均每天每个手术室2.5例。如果可以消除这种差异，换手术室的累积额外周转时间（每天每个手术室远低于1小时）肯定不允许增加另一个择期手术。一个灵活的调度政策，允许外科医生交换，而不是需要完整的块招致最小的额外工作人员的时间在手术室一天，同时允许时间表，以填补可用的选修病例。
To compare turnover times for a series of elective cases with surgeons following themselves to turnover times for a series of previously scheduled, elective procedures where the following surgeon differed from the preceding surgeon. We also considered the effect of changing procedure types and the time of day on turnover time. Retrospective, cohort study. University-affiliated teaching hospital. We used the operating room statistical database to gather 32 months of turnover data from a large academic institution. Turnover time data for the same-surgeon and surgeon-swap groups were batched by month to minimize autocorrelation and achieve data normalization. A two-way ANOVA using the monthly batched data was performed with surgeon swapping and changes in procedure category as variables of turnover time. Similar analyses were performed using individual surgical services and using hourly time intervals during the surgical day as additional covariates to surgeon swapping. The mean (95% confidence interval) same-surgeon turnover time was 43.6 (43.2 – 44.0) min versus 51.0 (50.5 – 51.6) min for a planned surgeon swap (p < 0.0001). This resulted in a difference (95% confidence interval) of 7.4 (6.8 – 8.1) min. The exact increase in turnover time was dependent on surgical service, change in subsequent procedure type, time of day when the turnover occurred, and turnover frequency per OR. The investigated institution averages 2.5 cases per OR per day. The cumulative additional turnover time (far less than one hour per operating room per day) for switching surgeons definitely does not allow the addition of another elective procedure if the difference could be eliminated. A flexible scheduling policy allowing surgeon swapping rather than requiring full blocks incurs minimal additional staffed time during the OR day while allowing the schedule to be filled with available elective cases.
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影响因子：
5.7
作者：
Dexter, F;Macario, A
通讯作者：
Macario, A
DOI：
10.1177/107155170301000202
发表时间：
2003-06-01
期刊：
Seminars in laparoscopic surgery
影响因子：
--
作者：
Sandberg, Warren S;Ganous, Timothy J;Steiner, Charles
通讯作者：
Steiner, Charles
影响因子：
5.7
作者：
Dexter, F;Macario, A;Lubarsky, DA
通讯作者：
Lubarsky, DA
影响因子：
8.8
作者：
Sandberg, WS;Daily, B;Rattner, D
通讯作者：
Rattner, D
影响因子：
5.7
作者：
Stepaniak, Pieter S.;Mannaerts, Guido H. H.;de Vries, Guus
通讯作者：
de Vries, Guus