Uncertainty in Knowing the Operating Rooms in Which Cases Were Performed Has Little Effect on Operating Room Allocations or Efficiency

2002 ◽  
Vol 95 (6) ◽  
pp. 1726-1730 ◽  
Author(s):  
Richard H. Epstein ◽  
Franklin Dexter
Keyword(s):  
Operating Room ◽  
Operating Rooms ◽  
Or Efficiency

scholarly journals Operating room efficiency in a low resource setting: a pilot study from a large tertiary referral center in Ethiopia

2022 ◽  
Vol 16 (1) ◽  
Author(s):  
Samuel Negash ◽  
Endale Anberber ◽  
Blen Ayele ◽  
Zeweter Ashebir ◽  
Ananya Abate ◽  
...  
Keyword(s):  
Operating Room ◽  
Operating Rooms ◽  
Turnover Time ◽  
High Rate ◽  
Start Time ◽  
Or Efficiency ◽  
Tertiary Referral Center ◽  
Resource Setting ◽  
Cancellation Rate ◽  
Patient Preparation

Abstract Background The operating room (OR) is one of the most expensive areas of a hospital, requiring large capital and recurring investments, and necessitating efficient throughput to reduce costs per patient encounter. On top of increasing costs, inefficient utilization of operating rooms results in prolonged waiting lists, high rate of cancellation, frustration of OR personnel as well as increased anxiety that negatively impacts the health of patients. This problem is magnified in developing countries, where there is a high unmet surgical need. However, no system currently exists to assess operating room utilization in Ethiopia. Methodology A prospective study was conducted over a period of 3 months (May 1 to July 31, 2019) in a tertiary hospital. Surgical case start time, end time, room turnover time, cancellations and reason for cancellation were observed to evaluate the efficiency of eight operating rooms. Results A total of 933 elective procedures were observed during the study period. Of these, 246 were cancelled, yielding a cancellation rate of 35.8%. The most common reasons for cancellation were related to lack of OR time and patient preparation (8.7% and 7.7% respectively). Shortage of facilities (instrument, blood, ICU bed) were causes of cancelation in 7.7%. Start time was delayed in 93.4% (mean 8:56 am ± 52 min) of cases. Last case completion time was early in 47.9% and delayed in 20.6% (mean 2:54 pm ± 156 min). Turnover time was prolonged in 34.5% (mean 25 min ± 49 min). Total operating room utilization ranged from 10.5% to 174%. Operating rooms were underutilized in 42.7% while overutilization was found in 14.6%. Conclusion We found a high cancellation rate, most attributable to late start times leading to delays for the remainder of cases, and lack of preoperative patient preparation. In a setting with a high unmet burden of surgical disease, OR efficiency must be maximized with improved patient evaluation workflows, adequate OR staffing and commitment to punctual start times. We recommend future quality improvement projects focusing on these areas to increase OR efficiency.

scholarly journals Design Opportunities to Reduce Waste in Operating Rooms

2021 ◽  
Vol 13 (4) ◽  
pp. 2207
Author(s):  
Charlotte Harding ◽  
Joren Van Loon ◽  
Ingrid Moons ◽  
Gunter De Win ◽  
Els Du Bois
Keyword(s):  
Operating Room ◽  
Circular Economy ◽  
Operating Rooms ◽  
Medical Waste ◽  
Waste Reduction ◽  
Infrastructure Management ◽  
Expert Interviews ◽  
Hospital Waste ◽  
Observation Results ◽  
Taking Care

While taking care of the population’s health, hospitals generate mountains of waste, which in turn causes a hazard to the environment of the population. The operating room is responsible for a disproportionately big amount of hospital waste. This research aims to investigate waste creation in the operating room in order to identify design opportunities to support waste reduction according to the circular economy. Eight observations and five expert interviews were conducted in a large sized hospital. The hospital’s waste infrastructure, management, and sterilization department were mapped out. Findings are that washable towels and operation instruments are reused; paper, cardboard, and specific fabric are being recycled; and (non-)hazardous medical waste is being incinerated. Observation results and literature findings are largely comparable, stating that covering sheets of the operation bed, sterile clothing, sterile packaging, and department-specific products are as well the most used and discarded. The research also identified two waste hotspots: the logistical packaging (tertiary, secondary, and primary) of products and incorrect sorting between hazardous and non-hazardous medical waste. Design opportunities include optimization of recycling and increased use of reusables. Reuse is the preferred method, more specifically by exploring the possibilities of reuse of textiles, consumables, and packaging.

scholarly journals Innovative Ventilation Technology for Operating Rooms

2018 ◽  
Vol 4 (1) ◽  
pp. 243-245 ◽  
Author(s):  
Sabine Gruber ◽  
Sebastian Buhl ◽  
Clemens Bulitta
Keyword(s):  
Operating Room ◽  
Clinical Setting ◽  
Bacterial Contamination ◽  
Ventilation System ◽  
Operating Rooms ◽  
Operating Theatre ◽  
Experimental Setting ◽  
Bacterial Burden

AbstractThe purpose of this work was to evaluate the decontamination potential of the Potok system both in an experimental setting in a research Operating Room (OR) with standalone Air Decontamination Units (Potok 150-M-01) and in a clinical setting in a real operating theatre in Moscow. Our experiments showed an impact of the Potok units on the bacterial contamination of the room air according to the Swedish SIS-TS 39:2015 standard. For the initial measurements in our research OR in Weiden this could be shown by a decrease of the bacterial burden at all three different measurement points (OR table, instrumentation tray, periphery). Also the subsequently done measurements in the Moscow hospital verified this decontaminating effectivity of the Potok system. In this case the initial background contamination of the operating theatre was higher than in the research OR in Germany. This bacterial burden could be effectively decreased by the use of the installed Potok based ventilation system.

Improving operating room productivity via parallel anesthesia processing

2014 ◽  
Vol 27 (8) ◽  
pp. 697-706 ◽  
Author(s):  
Michael J. Brown ◽  
Arun Subramanian ◽  
Timothy B. Curry ◽  
Daryl J. Kor ◽  
Steven L. Moran ◽  
...  
Keyword(s):  
Parallel Processing ◽  
Operating Room ◽  
Upper Extremity ◽  
Regional Anesthesia ◽  
Practice Change ◽  
Care Providers ◽  
Processing Efficiency ◽  
Or Efficiency ◽  
Content Type ◽  
Efficiency And Productivity

Purpose – Parallel processing of regional anesthesia may improve operating room (OR) efficiency in patients undergoes upper extremity surgical procedures. The purpose of this paper is to evaluate whether performing regional anesthesia outside the OR in parallel increases total cases per day, improve efficiency and productivity. Design/methodology/approach – Data from all adult patients who underwent regional anesthesia as their primary anesthetic for upper extremity surgery over a one-year period were used to develop a simulation model. The model evaluated pure operating modes of regional anesthesia performed within and outside the OR in a parallel manner. The scenarios were used to evaluate how many surgeries could be completed in a standard work day (555 minutes) and assuming a standard three cases per day, what was the predicted end-of-day time overtime. Findings – Modeling results show that parallel processing of regional anesthesia increases the average cases per day for all surgeons included in the study. The average increase was 0.42 surgeries per day. Where it was assumed that three cases per day would be performed by all surgeons, the days going to overtime was reduced by 43 percent with parallel block. The overtime with parallel anesthesia was also projected to be 40 minutes less per day per surgeon. Research limitations/implications – Key limitations include the assumption that all cases used regional anesthesia in the comparisons. Many days may have both regional and general anesthesia. Also, as a case study, single-center research may limit generalizability. Practical implications – Perioperative care providers should consider parallel administration of regional anesthesia where there is a desire to increase daily upper extremity surgical case capacity. Where there are sufficient resources to do parallel anesthesia processing, efficiency and productivity can be significantly improved. Originality/value – Simulation modeling can be an effective tool to show practice change effects at a system-wide level.

Simulation Modeling of the Operating Room Based on SIMIO

2010 ◽  
Vol 37-38 ◽  
pp. 1162-1166 ◽  
Author(s):  
Qian Zheng ◽  
Sai Feng Chen ◽  
Jie Shen ◽  
Ze Qing Liu ◽  
Kai Fang ◽  
...  
Keyword(s):  
Simulation Model ◽  
Operating Room ◽  
Simulation Modeling ◽  
Operating Rooms ◽  
Simulation Platform ◽  
Rational Utilization ◽  
Model Case ◽  
Satisfactory Degree

Operating rooms (OR) is one of the most demanding department in hospital. OR’s process will directly influence the profits of hospital as well as the patients' satisfactory degree. On the condition of a complex cooperation of ORs with variations, simulation has its advantage on solving problems. From the perspective point of rational utilization of resources, the simulation modeling of OR in big hospital by a latest simulation platform – SIMIO is proposed. The modeling objects and the logic underline are studied, and a simulation model case is presented.

scholarly journals Description of healthcare professionals’ attitudes on patient safety in the Tunisian operating rooms

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M A Tlili ◽  
H Sayeh ◽  
W Aouicha ◽  
M Souki ◽  
E Taghouti ◽  
...  
Keyword(s):  
Patient Safety ◽  
Human Factors ◽  
Operating Room ◽  
Healthcare Professionals ◽  
Participation Rate ◽  
Operating Rooms ◽  
Teaching Hospitals ◽  
Cross Sectional ◽  
Surgical Safety ◽  
Work Units

Abstract Background Currently, ensuring surgical safety remain a worldwide challenge. The description of operating room professionals' attitudes toward patient safety in their work units helps to identify strengths and weaknesses in term of patient safety, allowing a clearer vision of the safety aspects that require special attention. This study aimed to describe healthcare professionals' attitudes on patient safety in the Tunisian operating rooms. Methods This is a cross-sectional descriptive study spread over a 6-month period (October-April 2018). It was conducted among healthcare professionals working in the operating rooms of the two teaching hospitals of Sousse (Tunisia). The measuring instrument used is the Operating Room Management Attitudes Questionnaire (ORMAQ), which consists of 60 items spread over 8 dimensions. The latter has been subjected to a transcultural validation process inspired from the Vallerand method. Data entry and analysis was done by the Statistical Package for Social Sciences (SPSS.20) software. Results A total of 303 professionals participated in the study (participation rate= 76.13%). The most developed dimension was teamwork and the least developed was “Procedural errors/ compliance”. Items' results show that 94.8% of professionals confirmed that seniors should encourage medical and paramedical staff to ask questions, 53.5% of professionals stated that personal problems can adversely affect their performance and 87.5% agreed that operating rooms' team members share responsibilities for prioritizing activities in high workload situations. In addition, 50.9% of participants reported that the managers don't listen to staff or care about their concerns. Conclusions Operating rooms professionals' attitudes toward patient safety in their work units reflect an alarming situation regarding the quality of healthcare provided to patients. These results should be taken into consideration to guide future intervention on quality management improvement. Key messages Considering human factors is essential to improve safety in operating rooms and has an important role in reducing the occurrence of adverse events in these settings. It is important to study the underlying attitudes that determine the human factors for a better understanding and resolution of patient safety problems.

scholarly journals Organization of surgical services and operating room efficiency in Norwegian hospitals

2013 ◽  
Vol 2 (2) ◽  
pp. 61
Author(s):  
Dag Bratlid ◽  
Svein Petter Raknes
Keyword(s):  
Operating Room ◽  
Turnover Time ◽  
Macro Level ◽  
Organizational Strategies ◽  
Operating Room Efficiency ◽  
Or Efficiency ◽  
Emergency Operations ◽  
Surgical Services ◽  
Micro Level ◽  
Future Hospital

Background Most studies on operating room (OR) efficiency have focused on how local factors within the surgical facilities (micro level), such as turnover time, case duration and non-operative time, affects operating room efficiency. Few studies have analyzed how different strategies for organizing surgical services on the departmental or hospital level (macro level) might affect OR efficiency. Norwegian hospitals have organized their surgical services on the macro level along two different strategies. Most hospitals have separate facilities for out-patient surgery and in-patient surgery, often also geographically separated. Most hospitals also have specialty specific OR (orthopedics, gastroenterology, gynecology etc.), while in other hospitals different subspecialties share the same OR. This study was undertaken to analyze any effect of these different organizational strategies in relation to OR efficiency. Methods Data on organization of surgical services and operation volume for 2009 was gathered from eleven Norwegian university and larger county hospitals with a similar case mix. Total OR efficiency and OR efficiency during ordinary work hours were analyzed separately for out-patient and in-hospital surgery, including emergency operations. Calculation of OR during ordinary hours (8am-3pm) was based on 230 workdays per year, and included emergency operations. Results OR efficiency was 721 operations per OR per year with a range from 525 to 1049 and was not related to the different strategies for organizing these services. Furthermore, no correlation was found between OR efficiency and operation volume or number of OR. OR efficiency during ordinary hours and workdays was 3.6 operations per day for out-patient surgery and 1.8 for in-patient surgery including emergency operations. This was considerably less than standards used in planning surgical facilities in Norwegian hospitals. Conclusion OR efficiency is probably more related to organization of the surgical services on the micro level than to strategies for organizing these services on the macro level. The large variation in operating room efficiency in Norwegian hospitals indicates that many hospitals have a potential for improvement. The discrepancy between actual OR efficiency and standards used for planning of surgical facilities represents a challenge in future hospital planning.

Sequential Kidney Exchange

2014 ◽  
Vol 6 (3) ◽  
pp. 265-285 ◽  
Author(s):  
Lawrence M. Ausubel ◽  
Thayer Morrill
Keyword(s):  
Organ Donation ◽  
Operating Room ◽  
Incentive Compatibility ◽  
Operating Rooms ◽  
Kidney Exchange ◽  
Basic Insight

The traditional literature on kidney exchange assumes that all components of the exchange must occur simultaneously. Unfortunately, the number of operating rooms required for concurrent surgeries poses a significant constraint on the beneficial exchanges that may be attained. The basic insight of this paper is that incentive compatibility does not require simultaneous exchange; rather, it requires that organ donation occurs no later than the associated organ receipt. Using sequential exchanges may relax the operating room constraint and thereby increase the number of beneficial exchanges. We show that most benefits of sequential exchange can be accomplished with only two concurrent operating rooms. (JEL D47, I11)

Coping among nurses of the operating room and recovery room

2009 ◽  
Vol 3 (4) ◽  
pp. 823
Author(s):  
Laura De Azevedo Guido ◽  
Estela Regina Ferraz Bianchi ◽  
Graciele Fernanda da Costa Linch
Keyword(s):  
Problem Solving ◽  
Coping Strategies ◽  
Operating Room ◽  
Recovery Room ◽  
Descriptive Study ◽  
Operating Rooms ◽  
Quantitative Approach ◽  
Stress Adaptation ◽  
Human Being ◽  
Level Of Significance

Objective: to indentify the coping strategies used by nurses of the Operating Room and Recovery Room. Methods: this is a descriptive study, from quantitative approach. Data was collected by inventory of coping strategies of Lazarus and Folkman, which includes thoughts and actions used to deal with external or internal demands of a particular stressor, centralizing in the use of strategies for coping. The results were verified as statistically significant or not, stablishing the level of significance of 5%. Results: it was found that the confrontation and overcoming of stress in the workplace, converged for the pleasure and satisfaction of nurses. As the process is understood as an interactive model, in wich the relations between person and workplace interact constantly, it becomes evident that the adaptation of the human being to the different stress situations is necessary so that the adequate coping happens. Conclusion: it is concluded that the strategy used by nurses was more problem-solving and less used, the removal. Descriptors: stress; adaptation psychological; operating rooms.

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