The Effect of the Operating Room Coordinator's Risk Appreciation on Operating Room Efficiency
The Effect of the Operating Room Coordinator's Risk Appreciation on Operating Room Efficiency
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DOI：
10.1213/ane.0b013e318195e109
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发表时间：
2009-04-01
影响因子：
5.7
通讯作者：
de Vries, Guus
中科院分区：
文献类型：
--
作者：
Stepaniak, Pieter S.;Mannaerts, Guido H. H.;de Vries, Guus
背景：手术室协调员（ORC）负责填补每个手术室（OR）时间表的空白。我们观察到四个orc的性格不同，他们愿意在日常计划中承担更多的风险。待检验的假设是，四种ORC的个性与ORC愿意承担的延迟案例风险之间的关系会影响OR效率。方法：采用Zuckerman-Kuhlman人格调查问卷，对ORC的人格特征与计划进度冒险行为的关系进行评价。7名麻醉师被要求对每个ORC在计划中承担风险的意愿进行评分。为了分析哪种风险态度能提高手术室的效率，在2006年和2007年的5个月期间，将ORC的每日预后与实际的手术室项目结果进行了比较。我们分析了从医院管理层的角度来看，预留过多手术室时间的成本与预留过少手术室时间的成本是否平衡，这一结果是否与手术室中心的管理任务分配相一致。结果：7名麻醉师将4例orc分为风险规避组（n = 2）和非风险规避组（n = 2）。Zuckerman-Kuhlman人格问卷风险寻求结果表明，不同orc的风险欣赏存在差异。我们研究的主要发现是，与风险厌恶的ORC相比，非风险厌恶的ORC计划在更多的情况下填补手术室项目的空白。2006年，非风险规避机构比风险规避机构多执行的个案数目为188宗，2007年为174宗。非风险厌恶的ORC比风险厌恶的ORC平均每个手术室/天的项目结束时间晚34分钟（+/- 19分钟，P = 0.0085）。我们发现这家医院平均预留的手术时间比实际需要的要多。非风险厌恶型ORC比风险厌恶型ORC更能利用额外的手术室时间，在办公时间安排额外的病例。非风险厌恶型ORC的成功可以与这样一个事实联系起来，即由于这种过度预留，通常有时间可用。结论：本研究的结论是，与风险厌恶型ORC相比，非风险厌恶型ORC产生的未使用手术室容量显著减少，没有在正常工作时间后运行手术室或取消预定手术的选择性病例的很大机会。
BACKGROUND: The Operating Room Coordinator (ORC) is responsible for filling gaps in every operating room (OR) schedule. We have observed differences among the personalities of the four ORCs with regard to their willingness to agree to assume more risk concerning their daily planning. The hypothesis to be tested is that the relationship between the personality of each of the four ORCs and the risk an ORC is willing to take of cases running late affects OR efficiency.METHODS: In order to judge the personality of an ORC in relation to risk-taking in planning schedules, we applied the Zuckerman-Kuhlman Personality Questionnaire in our study. Seven anesthesiologists were asked to score every ORC on willingness to take risks in planning. To analyze which risk attitude creates more OR efficiency, the daily prognosis of the ORC compared with the actual OR program outcome was registered during a 5-mo period in 2006 and 2007. We analyzed whether, in the opinion of hospital management, the costs of reserving too much OR time balances with the costs of reserving too little OR time, and whether this result is consistent with the assignment of the management tasks of the ORC.RESULTS: Seven anesthesiologists classified the four ORCs into the risk-averse group (n = 2) and the nonrisk-averse group (n = 2). The Zuckerman-Kuhlman Personality Questionnaire results for risk-seeking indicate that there is a difference in risk appreciation among the different ORCs. The main finding in our study is that the nonrisk-averse ORC plans to fill the gaps in more cases in the OR program than the risk-averse ORC does. The number of extra cases performed by the nonrisk-averse ORC as compared to a risk-averse ORC is 188 in 2006 and 174 in 2007.The average end-of-program-time per OR/day for the nonrisk-averse ORC is 34 min (+/- 19 min, P = 0.0085) later than for the risk-averse ORC. We find that this hospital on average reserves more OR time for procedures than is actually required. The nonrisk-averse ORC takes more advantage of that extra OR time than the risk-averse ORC does by scheduling extra cases during office hours. The success of the nonrisk-averse ORC can be linked to the fact that there is usually time available due to this over-reserving.CONCLUSIONS: The conclusion of this study is that a nonrisk-averse ORC creates significantly less unused OR capacity without a great chance of running ORs after regular working hours or canceling elective cases scheduled for surgery compared to a risk-averse ORC.