Extended operating times are more efficient, save money and maintain a high staff and patient satisfaction

2018 ◽  
Vol 28 (9) ◽  
pp. 231-237 ◽  
Author(s):  
Jonathan Blair Thomas Herron ◽  
Rachel French ◽  
Andrew Douglas Gilliam
Keyword(s):  
Patient Satisfaction ◽  
Private Sector ◽  
Negative Impact ◽  
Target Position ◽  
Preoperative Assessment ◽  
Surgical Trainee ◽  
Performance Targets ◽  
Theatre Staff ◽  
Working Day ◽  
Trainee Satisfaction

Current public sector austerity measures necessitate efficiency savings throughout the NHS. Performance targets have resulted in activity being performed in the private sector, waiting list initiative lists and requests for staff to work overtime. This has resulted in staff fatigue and additional agency costs. Adoption of extended operating theatre times (0800-1800 hours) may improve productivity and efficiency, with potentially significant financial savings; however, implementation may adversely affect staff morale and patient compliance. A pilot period of four months of extended operating times (4.5 hour sessions) was completed and included all theatre surgical specialties. Outcome measures included: the number of cases completed, late starts, early finishes, cancelled operations, theatre overruns, preoperative assessment and 18-week targets. The outcomes were then compared to pre-existing normal working day operating lists (0900-1700). Theatre staff, patient and surgical trainee satisfaction with the system were also considered by use of an anonymous questionnaire. The study showed that in-session utilisation time was unchanged by extended operating hours 88.7% (vs 89.2%). The service was rated as ‘good’ or ‘excellent’ by 87.5% of patients. Over £345,000 was saved by reducing premium payments. Savings of £225,000 were made by reducing privately outsourced operation and a further £63,000 by reviewing staff hours. Day case procedures increased from 2.8 to 3.2 cases/day with extended operating. There was no significant increase in late starts (5.1% vs 6.8%) or cancellation rates (0.75% vs 1.02%). Theatre over-runs reduced from 5% to 3.4%. The 18 weeks target for surgery was achieved in 93.7% of cases (vs 88.3%). The number of elective procedures increased from 4.1 to 4.89 cases/day. Only 13.33% of trainees (n = 33) surveyed felt that extended operating had a negative impact on training. The study concludes that extended operating increased productivity from 2.8 patients per session to 3.2 patients per session with potential savings of just over £2.4 million per financial year. Extrapolating this to the other 155 trusts in England could be a potential saving of £372 million per year. Staff, trainee and patient satisfaction was unaffected. An improved 18 weeks target position was achieved with a significant reduction in private sector work. However, some staff had difficulty with arranging childcare and taking public transport and this may prevent full implementation.

HASTANELERİN HİZMET KALİTESİNİN HASTA TATMİN ÖLÇEĞİ İLE ÖLÇÜLMESİ: KARABÜK DEVLET HASTANESİNDE YATAN HASTALAR ÜZERİNDE BİR ARAŞTIRMA THE MEASUREMENT SERVICE QUALITY OF THE HOSPITALS BY THE PATIENT SCALE: A RESEARCH ON THE PATIENTS IN KARABUK STATE HOSP

2013 ◽  
Vol 1 (1) ◽  
pp. 100
Author(s):  
Selçuk Yurtsever
Keyword(s):  
Patient Satisfaction ◽  
Health Services ◽  
Literature Review ◽  
Private Sector ◽  
State Hospital ◽  
Continuous Change ◽  
Satisfaction Scale ◽  
The World ◽  
Main Factors

It has been known that both in the world and in Turkey a continuous change has been experienced in the provision of health services in recent years. In this sense by adopting the customer(client) focused approach of either public or private sector hospitals; it has been seen that they are in the struggle for presenting a right, fast, trustuble, comfy service. The purpose of this research is to measure the satisfaction degree, expectations and perceptions of the patients in Karabük State Hospital through comparison. In this context, the patient satisfaction scale which has been developed as a result of literature review has been used and by this scale it has been tried to measure the satisfaction levels of the patients in terms of material and human factors which are the two main factors of the service that was presented. In the study, with the scales of Servqual and 0-100 Points together, in the part of the analysis MANOVA have been used. The expectations and the perceptions of the patient has been compared first by generally and then by separating to different groups according to the various criterias and in thisway it has been tried to be measured their satisfaction levels. According to the results that were obtained, although, the satisfaction levels of the patients who have taken service from Karabük State Hospital are high in terms of thedoctors and the nurses; it has been reached to the result that their satisfaction levels are low in terms of the materials that have been used at the presenting of the service and the management.

scholarly journals 764 Human Factors in Operative Theatres During the Covid-19 Pandemic: A Cross-sectional Analysis of Operating Theatre Staff Experiences in a Regional Centre

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
L E Murchison ◽  
R Anbarasan ◽  
A Mathur ◽  
M Kulkarni
Keyword(s):  
Human Factors ◽  
Online Survey ◽  
Situational Awareness ◽  
Negative Impact ◽  
High Stress ◽  
Operating Theatre ◽  
Free Text ◽  
Cross Sectional ◽  
Chi Squared ◽  
Theatre Staff

Abstract Introduction In the already high-risk, high-stress environment of the operating theatre, operating during Covid-19 has brought its own unique challenges. Communication, teamwork and anxiety related new operating practices secondary to Covid-19 are hypothesised to have a negative impact on patient care. Method We conducted a single-centre online survey of operating theatre staff from 22nd June–6th July 2020. Respondents completed 18 human factors questions related to COVID-19 precautions including communication, teamwork, situational awareness, decision making, stress, fatigue, work environment and organisational culture. Questions consisted of yes/no responses, multiple choice and Likert items. Kruskall-Wallis tests, Chi-Squared, Mann Whitney U tests, Spearman’s correlation coefficient, lambda and Cramer’s V tests were used. Free-text responses were also reviewed. Results 116 theatre staff responded. Visual (90.5%), hearing/ understanding (96.6%) difficulties, feeling faint/lightheaded (66.4%) and stress (47.8%) were reported. Decreased situational awareness was reported by 71.5% and correlated with visors (r = 0.27 and p = 0.03) and FFP2/3 mask usage (r = 0.29 and p = 0.01). Reduced efficiency of theatre teams was reported by 75% of respondents and 21.5% felt patient safety was at greater risk due to Covid-19 precautions in theatre. Conclusions Organisational adjustments are required, and research focused on development of fit-for-purpose personal protective equipment (PPE).

scholarly journals P38 COVID-19 impact on Surgical Training And Recovery Planning (COVID-STAR) Survey

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
◽  
Joshua Clements
Keyword(s):  
Surgical Training ◽  
Negative Impact ◽  
Healthcare Delivery ◽  
Cross Sectional Study ◽  
Surgical Trainee ◽  
Surgical Specialty ◽  
Cross Sectional ◽  
Training Time ◽  
Surgical Trainees ◽  
And Training

Abstract Background The COVID-19 pandemic has resulted in dynamic changes to healthcare delivery. Surgery as a specialty has been significantly affected and with that the delivery of surgical training. Method This national, collaborative, cross sectional study comprising 13 surgical trainee associations distributed a pan surgical specialty survey on the COVID-19 impact on surgical training over a 4-week period (11th May - 8th June 2020). The survey was voluntary and open to medical students and surgical trainees of all specialties and training grades. All aspects of training were qualitatively assessed. This study was reported according to STROBE guidelines. Results 810 completed responses were analysed. (M401: F 390) with representation from all deaneries and training grades. 41% of respondents (n = 301) were redeployed with 74% (n = 223) redeployed > 4 weeks. Complete loss of training was reported in elective operating (69.5% n = 474), outpatient activity (67.3%, n = 457), Elective endoscopy (69.5% n = 246) with > 50% reduction in training time reported in emergency operating (48%, n = 326) and completion of work-based assessments (WBA) (46%, n = 309). 81% (n = 551) reported course cancellations and departmental and regional teaching programmes were cancelled without rescheduling in 58% and 60% of cases respectively. A perceived lack of Elective operative exposure and completions of WBA’s were the primary reported factor affecting potential training progression. Overall, > 50% of trainees (n = 377) felt they would not meet the competencies required for that training period. Conclusion This study has demonstrated a perceived negative impact on numerous aspects of surgical training affecting all training specialties and grades.

scholarly journals Enteral resorbable diet versus standard diet in primary sphincter reconstruction: a prospective randomised trial

2021 ◽  
Author(s):  
Andreas Joos ◽  
Dieter Bussen ◽  
Christian Galata ◽  
Christoph Reißfelder ◽  
Alexander Herold ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Healing Rate ◽  
Negative Impact ◽  
Randomised Trial ◽  
Sample Size Calculation ◽  
Standard Diet ◽  
Complication Rates ◽  
Significance Level ◽  
Sphincter Reconstruction ◽  
Prospective Randomised Trial

Abstract Aim Bowel movements after reconstructive anorectal surgery may negatively affect surgical outcome. This study was aimed to assess any differences between a standard diet (SD) and the enteral resorbable diet (ED) in terms of operative outcomes and patient tolerance after fistulectomy with primary sphincter reconstruction. Method Adult patients undergoing elective fistulectomy with primary sphincter reconstruction for anorectal and rectovaginal fistulas were eligible for inclusion. Patients were intraoperatively randomised to receive either the ED and peristalsis-inhibiting medication (ED) or a SD. The primary endpoint was the healing rate. Secondary endpoints included continence scores, complications and quality of life. Sample size calculation resulted in the analysis of 60 patients to detect a difference in fistula recurrence of 30% with 70% power and a 5% significance level. Results Sixty-six patients (24 women) were prospectively and randomly assigned to the ED (n = 34: 51%) or a SD (n = 32; 48%); mean age was 47 (18-74) years. The primary healing rate was 64 out of 66 patients (96%). No statistical difference in healing rate was seen between the groups. However, patient satisfaction was significantly higher in the SD group (P < 0.0001). Conclusions Fistulectomy with primary sphincter reconstruction is a safe method with low complication rates. Postoperative stool behaviour has no significant influence on the healing rate but has a significant negative impact on patient satisfaction. Therefore, maintaining a standard diet seems to be preferable following reconstructive anal surgery. Trial registration The trial was registered with the German Clinical Trials Register (DRKS00020524).

scholarly journals Pressure, Performance and Prestige: Dilemmas for Contemporary Professionals

2016 ◽  
Vol 23 (79) ◽  
pp. 539-552
Author(s):  
Ana Heloisa Costa Lemos ◽  
Leila Sharon Nasajon Gottlieb ◽  
Alessandra de Sá Mello da Costa
Keyword(s):  
Professional Growth ◽  
High Performance ◽  
Negative Impact ◽  
Well Being ◽  
Excessive Pressure ◽  
Performance Practices ◽  
Personal Lives ◽  
Work Intensification ◽  
Working Day ◽  
Mental Nature

Abstract Recent changes in the world of work have resulted in a greater level of work intensification. Whilst there have been gains in productivity, workers have been subject to increasing demands of both a physical and mental nature, which tend to have a negative impact on their well-being. Our interest in understanding this phenomenon has led to a qualitative study that seeks to analyse the experiences of professional graduates working in organizations that use high-performance practices, which tend to generate work intensification. The respondents revealed both the negative implications of work intensification, such as an increase in the working day, excessive pressure and sacrifices in their personal lives, as well as other aspects considered positive, such as learning, professional growth, autonomy and financial gains. These latter aspects deserve attention, since they can help us understand what leads qualified workers to accept intensified working practices.

Use of Surgical Risk Preoperative Assessment System (SURPAS) and Patient Satisfaction During Informed Consent for Surgery

2020 ◽  
Vol 230 (6) ◽  
pp. 1025-1033.e1 ◽  
Author(s):  
Brett M. Wiesen ◽  
Michael R. Bronsert ◽  
Davis M. Aasen ◽  
Abhinav B. Singh ◽  
Anne Lambert-Kerzner ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Informed Consent ◽  
Preoperative Assessment ◽  
Assessment System ◽  
Surgical Risk

scholarly journals The Impact of Government Debt Issuance on Short-Term interest rates in Indonesia

2009 ◽  
Vol 11 (3) ◽  
pp. 301
Author(s):  
Sri Adiningsih
Keyword(s):  
Fiscal Policy ◽  
Private Sector ◽  
Financial Markets ◽  
Interest Rates ◽  
Budget Deficit ◽  
Negative Impact ◽  
Government Debt ◽  
Crowding Out ◽  
Short Term ◽  
The Impact

This paper analyzes whether the expansionary fiscal policy funded by issuing debt instruments in financial markets will increase short-term interest rates. If  the expansionary fiscal policy increases interest rates, which decrease private spending especially investment, crowding out occurs. This is interesting because global economic crisis has encouraged many countries to run large budget deficits to stimulate the economy. Indonesia has also run budget deficit during this crisis and even in years before. The impact of such a policy can be significant because Indonesia’s debt market is still narrow and shallow. Therefore, its capability of absorbing the government debt instruments without influencing the private sector funding is limited. This study tests whether the crowding out occurs in Indonesia using a time series econometric model inspired by Cebula and Cuellar’s model. The Cointegration Regression and Error Correction Model (ECM) are used in this study. Monthly data from April 2000 to December 2008 are used for overnight real interbank call money interest rates, real net government bond issues in trading, real narrow money supply, real rate of one-month Certificate of Bank Indonesia, growth of Gross Domestic Product, and real net international capital flows. This empirical study shows that the crowding out problem occurred in Indonesia during the period. This indicates that financing budget deficit in Indonesia by issuing debt instruments in the financial markets has a negative impact on the private sector.

scholarly journals Assessment of Anxiety due to COVID-19 among the Surgery Staff of the René ESSOMBA Theater "BORE" at the Yaoundé Central Hospital

2021 ◽  
Vol 1 ◽  
pp. 19-25
Author(s):  
Biwole Daniel ◽  
Messina Ebogo ◽  
Bombah Freddy ◽  
Enrique Zoa Nkoa ◽  
Yannick Ekani Boukar ◽  
...  
Keyword(s):  
Negative Impact ◽  
Severe Depression ◽  
Cross Sectional Study ◽  
Operating Theatre ◽  
Central Hospital ◽  
Cross Sectional ◽  
Theatre Staff ◽  
Psychological Assistance ◽  
Collection Form ◽  
Professional Information

Background: The COVID-19 pandemic has had a negative impact on healthcare systems worldwide, including surgical disciplines. To date, only a few studies have assessed the effects of the ongoing pandemic on the mental state of those potentially exposed through their daily activities, such as operating theatre staff. The present study aimed to determine the prevalence of anxiety among the operating theatre staff "BORE" during the COVID-19 pandemic. Methods: From 13 January to 19 February 2021, we conducted a cross-sectional study using a pre-designed online form. This form was disseminated to participants via social networks. The data collection form was divided into three parts: one part was for socio-demographic information, the second part was for professional information, and the third part was for assessing the anxiety score by the Hamilton Anxiety Scale (HAM-A). Results: A total of 42 questionnaires were fully completed and retained for analysis. The sex ratio was 1.67, with 16 men and 26 women. COVID-19 anxiety with mild severity (HS ˂ 17) was found in 22 (55.4%) of the participants, and 33.3% had moderate to severe depression, while 11.3% had severe anxiety. Conclusion: About 4/5 of the participants in our survey suffered from anxiety due to the COVID-19 pandemic. This study highlights the need for psychological assistance for health care workers, especially the operating theatre staff of the Yaounde Central Hospital.

scholarly journals A Study on Impact of FDI on Selected Private Sector Insurance Companies in India

2017 ◽  
Author(s):  
C.K. Hebbar ◽  
Meenakshi Acharya
Keyword(s):  
Private Sector ◽  
Negative Impact ◽  
Insurance Industry ◽  
Secondary Data ◽  
Insurance Companies ◽  
Insurance Markets ◽  
Insurance Sector ◽  
Previous Level ◽  
The Impact ◽  
Indian Insurance

India is one among the most promising emerging insurance markets in the world. Indian insurance sector was liberalised in 2001. The insurance industry in India has undergone transformational changes over the last 15 years. In July 2014, the Cabinet Committee on Economic Affairs (CCEA) approved 49% FDI in insurance from the previous level of 26%. This paper aimed at examining the impact of FDI on the performance of selected private sector insurance companies. The study is based on secondary data and it is a descriptive study. This paper found that FDI had a significant positive as well as negative impact on areas which were studied in the paper.

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