Use of Anesthesia Induction Rooms Can Increase the Number of Urgent Orthopedic Cases Completed within 7 Hours

2005 ◽  
Vol 103 (2) ◽  
pp. 401-405 ◽  
Author(s):  
Paulus M. Torkki ◽  
Riitta A. Marjamaa ◽  
Markus I. Torkki ◽  
Pentti E. Kallio ◽  
Olli A. Kirvelä
Keyword(s):  
Operating Room ◽  
Turnover Time ◽  
Anesthesia Induction ◽  
Prospective Analysis ◽  
New Model ◽  
The Mean ◽  
Time Savings ◽  
Working Day ◽  
Room Model ◽  
The Impact

Background Mean turnover times and the time spent in the operating room (OR) can be reduced by concurrent induction of anesthesia. Previous studies of anesthesia induction outside the OR have concentrated either on anesthesia-controlled time or turnover time. The goal of this study was to investigate the impact of an induction room model on the whole surgical process, its phases and delays between the phases, and the number of cases performed during the 7-h working day. Methods A prospective analysis of OR times was conducted for 5 weeks with the traditional induction-in-the-OR model followed by 4 weeks with a new model: A team of two nurses and one anesthesiologist was added to one OR to perform parallel anesthesia induction in a separate induction room. The durations of phases of surgical process, number of completed cases between 7:45 am and 3:00 pm, and daily raw utilization of the OR were assessed. Results were compared to those measured before the intervention. Results The mean nonoperative time was reduced by 45.6%, whereas surgery time remained unchanged. The time savings contributed to the concurrent anesthesia induction and the cut down in delays between the phases. The new model allowed one additional case to be performed during the 7-h working day. Conclusions Anesthesia induction outside the OR can increase the number of surgical cases performed during a regular workday.

scholarly journals The Effect of Mean Load for S355J0 Steel with Increased Strength

Metals ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. 209 ◽  
Author(s):  
Roland Pawliczek ◽  
Dariusz Rozumek
Keyword(s):  
Fatigue Life ◽  
Mean Value ◽  
Mean Stress ◽  
Good Compliance ◽  
New Model ◽  
Proposed Model ◽  
Calculation Results ◽  
The Mean ◽  
Increased Strength ◽  
The Impact

The paper presents an algorithm for calculating the fatigue life of S355J0 steel specimens subjected to cyclic bending, cyclic torsion, and a combination of bending and torsion using mean stress values. The method of transforming cycle amplitudes with a non-zero mean value into fatigue equivalent cycles with increased amplitude and zero mean value was used. Commonly known and used transformation dependencies were used and a new model of the impact of the mean stress value on the fatigue life of the material was proposed. The life calculated based on the proposed algorithm was compared with the experimental life. It has been shown that the proposed model finds the widest application in the load cases studied, giving good compliance of the calculation results with the experimental results.

scholarly journals The economic impact of rostering junior doctors to triage to assist nursing staff in the early part of the patient journey through the emergency department

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261303
Author(s):  
David Brain ◽  
David Johnson ◽  
Julia Hocking ◽  
Angela T. Chang
Keyword(s):  
Emergency Department ◽  
Administrative Databases ◽  
Decision Analytic Model ◽  
Junior Doctors ◽  
Model Of Care ◽  
Patient Journey ◽  
New Model ◽  
Cost Minimisation Analysis ◽  
The Mean ◽  
The Impact

Objective This study aims to determine whether redeploying junior doctors to assist at triage represents good value for money and a good use of finite staffing resources. Methods We undertook a cost-minimisation analysis to produce new evidence, from an economic perspective, about the costs associated with reallocating junior doctors in the emergency department. We built a decision-analytic model, using a mix of prospectively collected data, routinely collected administrative databases and hospital costings to furnish the model. To measure the impact of uncertainty on the model’s inputs and outputs, probabilistic sensitivity analysis was undertaken, using Monte Carlo simulation. Results The mean costs for usual care were $27,035 (95% CI $27,016 to $27,054), while the mean costs for the new model of care were $25,474, (95% CI $25,453 to $25,494). As a result, the mean difference was -$1,561 (95% CI -$1,533 to -$1,588), with the new model of care being a less costly approach to managing staffing allocations, in comparison to the usual approach. Conclusion Our study shows that redeploying a junior doctor from the fast-track area of the department to assist at triage provides a modest reduction in cost. Our findings give decision-makers who seek to maximise benefit from their finite budget, support to reallocate personnel within the ED.

Introduction of Anesthesia Resident Trainees to the Operating Room Does Not Lead to Changes in Anesthesia-controlled Times for Efficiency Measures

2004 ◽  
Vol 101 (5) ◽  
pp. 1210-1214 ◽  
Author(s):  
Sunil Eappen ◽  
Hugh Flanagan ◽  
Neil Bhattacharyya
Keyword(s):  
Operating Room ◽  
First Year ◽  
Anesthesia Induction ◽  
Operating Room Efficiency ◽  
Efficiency Measures ◽  
Important Concern ◽  
Operating Room Information Systems ◽  
Induction Times ◽  
The Impact ◽  
Anesthesia Residents

Background Operating room efficiency is an important concern in most hospitals today. Little work has been reported to evaluate the contribution of anesthesia residents to changes in anesthesia-controlled time-related efficiencies in the operating room. The goal of this study was to measure the impact of the initiation of new residents to the operating room on anesthesia-related time measures of operating room efficiency. Methods Using the computerized operating room information systems, specific data regarding anesthesia-controlled times were extracted over three distinct 2-week periods over the course of 1 academic year. These included the first 2 weeks of July, when most of the operating rooms were staffed by attending physicians working alone; 2 weeks in September when new anesthesia residents were working in a 2:1 ratio with staff; and 2 weeks in May. The induction times, emergence times, and room turnover times were compared over these three periods for first-year anesthesia residents. Standard descriptive statistics were computed. Analysis of variance testing was then conducted comparing each of these time periods. Significance was set at P < 0.05. Results A total of 3,004 surgical procedures were performed during the 2-week study periods in July, September, and May, respectively. For the July, September, and May groups, the mean anesthesia induction times were 17.3, 19.0, and 20.8 min (P = 0.047); the emergence times were 8.7, 9.7, and 10.0 min, (P = 0.024); and the corresponding mean room turnover times were 47.6, 48.5, and 48.6 min (P = 0.907), respectively. Conclusion Although statistically significant time differences were found, these data strongly suggest that the initiation of anesthesia trainees to the operating room has no clinically or economically meaningful adverse effect on the anesthesia-controlled time component of operating room efficiency.

Asteroid and Comet Impact Speeds upon Mars: Significance for Panspermia and the Supply of Organics

1997 ◽  
Vol 161 ◽  
pp. 197-201 ◽  
Author(s):  
Duncan Steel
Keyword(s):  
Probability Distributions ◽  
Regions Of Interest ◽  
Significant Fraction ◽  
Organic Chemicals ◽  
Impact Speed ◽  
The Mean ◽  
The Impact

AbstractWhilst lithopanspermia depends upon massive impacts occurring at a speed above some limit, the intact delivery of organic chemicals or other volatiles to a planet requires the impact speed to be below some other limit such that a significant fraction of that material escapes destruction. Thus the two opposite ends of the impact speed distributions are the regions of interest in the bioastronomical context, whereas much modelling work on impacts delivers, or makes use of, only the mean speed. Here the probability distributions of impact speeds upon Mars are calculated for (i) the orbital distribution of known asteroids; and (ii) the expected distribution of near-parabolic cometary orbits. It is found that cometary impacts are far more likely to eject rocks from Mars (over 99 percent of the cometary impacts are at speeds above 20 km/sec, but at most 5 percent of the asteroidal impacts); paradoxically, the objects impacting at speeds low enough to make organic/volatile survival possible (the asteroids) are those which are depleted in such species.

Sound Production Treatment for Acquired Apraxia of Speech: An Examination of Dosage in Relation to Probe Performance

2020 ◽  
pp. 1-16
Author(s):  
Julie L. Wambaugh ◽  
Lydia Kallhoff ◽  
Christina Nessler
Keyword(s):  
Retrospective Analysis ◽  
Sound Production ◽  
Apraxia Of Speech ◽  
Practice Schedule ◽  
Practice Schedules ◽  
Baseline Performance ◽  
The Mean ◽  
Number Of Treatment ◽  
The Impact

Purpose This study was designed to examine the association of dosage and effects of Sound Production Treatment (SPT) for acquired apraxia of speech. Method Treatment logs and probe data from 20 speakers with apraxia of speech and aphasia were submitted to a retrospective analysis. The number of treatment sessions and teaching episodes was examined relative to (a) change in articulation accuracy above baseline performance, (b) mastery of production, and (c) maintenance. The impact of practice schedule (SPT-Blocked vs. SPT-Random) was also examined. Results The average number of treatment sessions conducted prior to change was 5.4 for SPT-Blocked and 3.9 for SPT-Random. The mean number of teaching episodes preceding change was 334 for SPT-Blocked and 179 for SPT-Random. Mastery occurred within an average of 13.7 sessions (1,252 teaching episodes) and 12.4 sessions (1,082 teaching episodes) for SPT-Blocked and SPT-Random, respectively. Comparisons of dosage metric values across practice schedules did not reveal substantial differences. Significant negative correlations were found between follow-up probe performance and the dosage metrics. Conclusions Only a few treatment sessions were needed to achieve initial positive changes in articulation, with mastery occurring within 12–14 sessions for the majority of participants. Earlier occurrence of change or mastery was associated with better follow-up performance. Supplemental Material https://doi.org/10.23641/asha.12592190

Impact of changing rainfall conditions on surface and groundwater resources in an experimental watershed in Greece

2013 ◽  
Vol 12 (2) ◽  
pp. 119-125
Keyword(s):  
Groundwater Resources ◽  
Annual Runoff ◽  
Annual Rainfall ◽  
Rainfall Regime ◽  
Winter Rainfall ◽  
Rainfall Depth ◽  
Rainfall Volume ◽  
The Mean ◽  
Groundwater Reserves ◽  
The Impact

The present study concerns the impact of a change in the rainfall regime on surface and groundwater resources in an experimental watershed. The research is conducted in a gauged mountainous watershed (15.18 km2) that is located on the eastern side of Penteli Mountain, in the prefecture of Attica, Greece and the study period concerns the years from 2003 to 2008. The decrease in the annual rainfall depth during the last two hydrological years 2006-2007, 2007-2008 is 10% and 35%, respectively, in relation to the average of the previous years. In addition, the monthly distribution of rainfall is characterized by a distinct decrease in winter rainfall volume. The field measurements show that this change in rainfall conditions has a direct impact on the surface runoff of the watershed, as well as on the groundwater reserves. The mean annual runoff in the last two hydrological years has decreased by 56% and 75% in relation to the average of the previous years. Moreover, the groundwater level follows a declining trend and has dropped significantly in the last two years.

(Preprint)

2018 ◽  
Author(s):  
Natalia Banasik ◽  
Dariusz Jemielniak ◽  
Wojciech P?dzich
Keyword(s):  
Medical Condition ◽  
Extended Period ◽  
Well Being ◽  
Marginal Effect ◽  
Life Duration ◽  
Significant Difference ◽  
The Mean ◽  
Academic Teachers ◽  
Length Of Life ◽  
The Impact

BACKGROUND There have been mixed results of the studies checking whether prayers do actually extend the life duration of the people prayed for. Most studies on the topic included a small number of prayers and most of them focused on people already struggling with a medical condition. Intercessory prayer’s influence on health is of scholarly interest, yet it is unclear if its effect may be dependent on the number of prayers for a named individual received per annum. OBJECTIVE We sought to examine if there is a noticeable increased longevity effect of intercessory prayer for a named individual’s well-being, if he receives a very high number of prayers per annum for an extended period. METHODS We retrieved and conducted a statistical analysis of the data about the length of life for 857 Roman Catholic bishops, 500 Catholic priests, and 3038 male academics from the US, France, Italy, Poland, Brazil, and Mexico. We obtained information for these individuals who died between 1988 and 2018 from Wikidata, and conducted an observational cohort study. Bishops were chosen for the study, as they receive millions of individual prayers for well being, according to conservative estimates. RESULTS There was a main effect for occupation F(2, 4391) = 4.07, p = .017, ηp 2 = .002, with pairwise comparisons indicating significant differences between the mean life duration of bishops (M=30489) and of priests (M=29894), but none between the academic teachers (M=30147) and either of the other groups. A comparison analysis between bishops from the largest and the smallest dioceses showed no significant difference t(67.31)=1.61, p = .11. Our main outcome measure is covariance of the mean length of life in each of the categories: bishops, priests, academic teachers, controlled for nationality. CONCLUSIONS The first analysis proved that bishops live longer than priests, but due to a marginal effect size this result should be treated with caution. No difference was found between the mean length of life of bishops from the largest and the smallest dioceses. We found no difference between bishops and male academics. These results show that the impact of intercessory prayers on longevity is not observable.

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