Factors Related to Hospital Operating Room Scheduling of the Performance in the Medical Center

2013 ◽  
Vol 740 ◽  
pp. 300-305
Author(s):  
Chi Ming Pu ◽  
Jen Der Leu ◽  
Hsueh Ling Ku
Keyword(s):  
Length Of Stay ◽  
General Anesthesia ◽  
Operating Room ◽  
Surgical Procedures ◽  
Medical Center ◽  
Operating Time ◽  
Surgical Patient ◽  
Or Efficiency ◽  
Implementation Data ◽  
Surgical Operations

Objective:This study examines the 2009 patient operating room (OR) length of stay data for a medical center in Taipei City. Using a statistical method based on regression analysis, the crucial factors that influence OR efficiency and performance were identified. The analytical results indicated that surgical procedures with general anesthesia and high surgical complexity incurred high surgical fees. Additionally, the anesthesia fees, operating time, and operating time variance rises as the squared number of surgical procedures increases. Therefore, for the hospitals 2010 OR scheduling management strategy, we adjusted the priority regulations for daily OR use to enhance the safety and quality of surgical patient health care and improve OR efficiency.Method:We collected 11 case ORs, that is, 9 inpatient and 2 outpatient ORs, for this study. The pre-implementation data were collected between January 1, 2009, and December 31, 2009. The post-implementation data were collected between January 1, 2010, and December 31, 2010; both forms of data included patients OR length of stay information. Furthermore, the indicators that were compared and analyzed for this study included variances in the number of cases in which general anesthesia was administered, the number of scheduled surgical procedures, the number of emergency surgical procedures, and OR use rates.Results:A total of 20,731 surgical operations were performed in 2009, among which general anesthesia was administered 6,925 times, 10,122 scheduled surgical procedures were performed, 1,305 emergency surgical procedures were performed, and the OR use rate was 70.30%. A total of 21,105 surgical operations were performed in 2010, among which general anesthesia was administered 7,106 times, 10,549 scheduled surgical procedures were performed, 1,319 emergency surgical procedures were performed, and the OR use rate was 71.05%.

scholarly journals EP.WE.782Retrospective analysis of acute surgical admissions during COVID-19 pandemic

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Shenbaga Rajamanikam ◽  
Suzzana Argyropoulos ◽  
Reza Arsalani Zadeh
Keyword(s):  
Length Of Stay ◽  
Hospital Stay ◽  
Surgical Procedures ◽  
Length Of Hospital Stay ◽  
Period Length ◽  
Surgical Patients ◽  
Surgical Team ◽  
Surgical Operations

Abstract Background COVID-19 pandemic has affected the number of surgical admissions and the number of emergency general surgical operations performed. COVID-19 pandemic has also led to changes in how some of the acute surgical patients were managed. Aim of the study was to compare acute surgical admissions and number of emergency general surgical procedures in this period. Material and Method We retrospectively analyzed acute surgical admissions during the pandemic from 20/3/20 to 19/4/20 and compared it with acute surgical admissions during pre-COVID-19 period from 1/11/2019 to 30/11/2019. Results During the COVID-19 pandemic 97 patients were assessed and admitted by the General surgical team, during the pre COVID-19 period 205 patients were assessed and admitted by the General surgical team. The number of acute surgical admissions during COVID-19 pandemic dropped by 53%. There were 46% less emergency surgeries performed during COVID 19 pandemic period. Length of stay during and before the COVID-19pandemic were 4.1 vs 4.4 days. Conclusion During the COVID-19 pandemic number of acute surgical admissions and the number of emergency surgeries were fewer than during pre COVID-19 pandemic. Length of hospital stay was less during COVID-19 pandemic.

scholarly journals The effect of the preoperative anaesthesiological interview on the levels of stress and anxiety of the heart surgical patient

2016 ◽  
Vol 10 (4) ◽  
pp. 2237-2240
Author(s):  
Androula C. Karaolia ◽  
Georgios I. Tagarakis ◽  
Elena Argyriadou ◽  
Ilias Bonotis ◽  
Ioannis Alexiou ◽  
...  
Keyword(s):  
Trait Anxiety ◽  
Surgical Procedures ◽  
Heart Surgery ◽  
Intervention Group ◽  
Positive Influence ◽  
Control Group ◽  
Surgical Patient ◽  
Test Results ◽  
State Trait Anxiety Inventory ◽  
Surgical Operations

Background. Stress and Anxiety are commonly observed before major surgical procedures, such as heart surgical operations. Aim of the current study is to investigate the effect of the preoperative anaesthesiological interview on these parameters. Methods. We prospectively included in the study 152 patients planned to undergo elective heart surgery. All patients were examined with the State-Trait anxiety inventory (STAI) scale on admission and again before surgery (prior to the anaesthesiological interview for the control group and after the latter for the intervention group). Results. Members of the control group had significantly higher levels of stress based on the test results, on the day prior to surgery. On the contrary, the members of the intervention group had significantly lower levels of stress on the same day. Conclusions. The anaesthesiological interview has a positive influence as it lowers the preoperative levels of stress and anxiety. 

A Successful Organized Effort to Improve Operating Room First-Case Starts in a Tertiary Academic Medical Center

2020 ◽  
pp. 000313482095143
Author(s):  
Melissa M. J. Chua ◽  
Keith Lewis ◽  
Yi-An Huang ◽  
Mary Fingliss ◽  
Alik Farber
Keyword(s):  
Operating Room ◽  
Medical Center ◽  
Academic Medical Center ◽  
Or Efficiency ◽  
Patient Dissatisfaction ◽  
Real Time Measurement ◽  
First Case ◽  
Academic Medical ◽  
Improve Operating Room ◽  
Operational Plan

Background Operating room (OR) inefficiency drives up cost, decreases revenue, and leads to surgeon, staff, and patient dissatisfaction. Given a low mean first-case start rate in our tertiary academic medical center, we developed a process to improve first-case start rates in an effort to increase OR efficiency. Methods A working group of the OR Executive Committee was constituted to develop and implement a multistep operational plan. This plan was predicated on a sensible staggered start framework, coordination of stakeholder responsibilities, a visual preoperative Stop/Go checklist tool, real-time measurement, and feedback. Results Within 11 days of implementation, 95% of first-start OR cases were tracked to start on time. Throughout the observation period (May 2015-July 2016), the goal of a daily mean 80% on-time start rate was either met or exceeded. Conclusions Implementation of an organized collaborative effort led to dramatic improvements in first OR case on-time rates. Such improvement in OR utilization may lead to an increase in staff and patient satisfaction and cost reduction.

scholarly journals Recovery Profiles of Sevoflurane and Desflurane with or without M-Entropy Guidance in Obese Patients: A Randomized Controlled Trial

2021 ◽  
Vol 11 (1) ◽  
pp. 162
Author(s):  
Yu-Ming Wu ◽  
Yen-Hao Su ◽  
Shih-Yu Huang ◽  
Po-Han Lo ◽  
Jui-Tai Chen ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Operating Room ◽  
Medical Center ◽  
Controlled Trial ◽  
Clinical Signs ◽  
Tracheal Extubation ◽  
Number Needed To Treat ◽  
Obese Patients ◽  
Anesthetic Depth ◽  
Eye Opening

Obesity increases the risk of prolonged emergence from general anesthesia due to the delayed release of anesthetic agents from body fat. This trial aimed to evaluate the effects of sevoflurane and desflurane along with anesthetic depth monitoring on emergence time from anesthesia in obese patients. Adults with a body mass index ≥ 30 kg·m−2 undergoing laparoscopic sleeve gastrectomy at a medical center were randomized into four groups: sevoflurane or desflurane anesthesia with or without M-Entropy guidance on anesthetic depth in a ratio of 1:1:1:1. In the M-Entropy guidance groups, the dosage of sevoflurane and desflurane was adjusted to achieve response and state entropy values between 40 and 60 during surgery. In the non-M-Entropy guidance groups, the dosage of anesthetics was titrated according to clinical signs. Primary outcome was time to spontaneous eye opening. A total of 80 participants were randomized. Compared to sevoflurane, desflurane anesthesia significantly reduced the time to spontaneous eye opening [mean difference (MD): −129 s; 95% confidence interval (CI): −211, −46], obeying commands (−160; −243, −77), tracheal extubation (−172; −266, −78), and leaving operating room (−148; −243, −54). M-Entropy guidance further reduced time to eye opening (MD: −142 s; 99.2% CI: −276, −8), tracheal extubation (−199; −379, −19), and leaving operating room (−190; −358, −23) in the desflurane but not the sevoflurane group. M-Entropy guidance significantly reduced the risk of agitation during emergence, i.e., risk difference: −0.275 (95% CI: −0.464, −0.086); and number needed to treat: 4. Compared to sevoflurane, using desflurane to maintain general anesthesia accelerated the return of consciousness in obese patients. M-Entropy guidance further hastened awakening in patients using desflurane and prevented emergence agitation.

scholarly journals 176. Topical Antibiotic and Antiseptic Use in the Operating Room: An Opportunity for Antimicrobial Stewardship?

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S197-S197
Author(s):  
Josef Hadib Nissan ◽  
Nina Naeger Murphy ◽  
Nilam Patel ◽  
Mary Borovicka ◽  
Michelle Hecker ◽  
...  
Keyword(s):  
Operating Room ◽  
Surgical Procedures ◽  
Antimicrobial Stewardship ◽  
Adverse Drug Events ◽  
Medical Center ◽  
Tertiary Care ◽  
Prosthetic Material ◽  
Topical Antibiotic ◽  
Topical Antibiotics ◽  
Tertiary Care Medical Center

Abstract Background Data suggest that topical antibiotic and antiseptic use in the operating room is common but not commonly monitored by antimicrobial stewardship programs. Although some data suggest a benefit in certain surgical procedures, the CDC and WHO advise against the routine use of topical antibiotics in surgery due to uncertainty and heterogeneity in the overall data. Methods We conducted a retrospective 28-day period prevalence study of topical antibiotic and antiseptic use during surgical procedures performed in the operating room by 6 surgical specialties at a tertiary care medical center. For the subset of patients undergoing orthopedic surgeries, we evaluated the types of topical antibiotics received and the rates of surgical site infections (SSI) and adverse drug events within 28 days of the procedure. Results Of 744 surgical procedures reviewed, topical antibiotics were used in 127 (17.1%), topical antiseptics in 71 (9.5%), and both in 18 (2.4%) (Table 1). Antiseptic use was higher in orthopedics relative to all other surgical specialties while topical antibiotic use was higher in neurosurgery. Hand, vascular and plastics had distinguishably lower use. In the orthopedic subgroup, after exclusions, 218 procedures were evaluated. Topical antibiotics were used in 42 (19.2%). Topical antibiotic therapy was more likely to be administered if prosthetic material was implanted, the procedure was emergent, or if a Staphylococcus aureus infection was present. Vancomycin was the most commonly used topical antibiotic and powder was the most commonly used type of application. As shown in table 2, SSI occurred more often when both topical antibiotics and antiseptics were applied; however, SSI events were relatively uncommon, and these were more likely to have infection present at the time of surgery. Adverse events were rare. Conclusion In our institution we noted significant variability in use of topical antibiotic and antiseptic therapy among surgical specialties as well as within the orthopedic surgical specialty. Although opportunities to standardize use/nonuse of these therapies exist, this may be challenging due to the uncertainty and heterogeneity of currently available data. Disclosures All Authors: No reported disclosures

Anesthesia for Procedures in the Intensive Care Unit and the Neonatal Intensive Care Unit

2011 ◽  
pp. 244-250
Author(s):  
John K. Stene ◽  
Carolyn A. Barbieri
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
General Anesthesia ◽  
Operating Room ◽  
Surgical Procedures ◽  
Neonatal Intensive Care ◽  
Percutaneous Tracheostomy ◽  
Critically Ill Patient ◽  
Anesthesia Practice ◽  
Endoscopic Gastrostomy

Anesthesiologists who are assigned to provide anesthesia for operations in the intensive care unit (ICU) must adapt principles of safe and effective anesthesia practice to this novel outside-of-the-operating-room environment. Among the reasons to perform surgical procedures at the bedside in the ICU is the avoidance of transporting an unstable, critically ill patient from the ICU to the operating room. Therefore, patients who need anesthesia care to undergo surgical procedures in the ICU can present a major challenge, The types of procedures performed in the ICU include those under local anesthesia (chest tubes, thoracentesis, diagnostic peritoneal lavage, diagnostic ultrasound; pericardiocentesis), and common procedures under general anesthesia (percutaneous tracheostomy, percutaneous endoscopic gastrostomy (PEG), esophagogastroduodenoscopy (EGD), and transesophageal echocardiogram (TEE)), as well as uncommon procedures under general anesthesia (thoracotomy, laparotomy, and amputation).

scholarly journals Cause and incidence of Cancellation of elective surgeries at Gondar University hospital, Ethiopia

2020 ◽  
Author(s):  
Yonas Addisu Nigatu ◽  
Habitu Adane Aytolign
Keyword(s):  
Operating Room ◽  
Surgical Procedures ◽  
Preoperative Assessment ◽  
Economic Loss ◽  
Daily Basis ◽  
University Hospital ◽  
Surgical Patient ◽  
North West ◽  
Elective Surgical Procedures ◽  
Gondar University Hospital

Abstract Background: High rates of cancellation of surgical procedures are common in hospital settings which may subsequently lead to economic loss to hospital besides burden given to patients, their families and medical teams .It is well recognized that cancellation of patients from elective theatre operating lists increases cost, decreases efficiency, duplicates workload and wastes operating room time.Cancellation of elective surgical procedures also causes significantly emotional trauma to the patients as well as their families and the community in general, and its impact on hospital resources is great due to prolonged hospitalization and high cost of health care.The aim of this study was to find the causes and incidence of surgical patient cancellation at Gondar university hospital, North-west Ethiopia.Methods: prospective observational study was conducted from January 10 to April 10, 2019. Information regarding the cancellation of surgeries were collected from various sources including; the operating room daily surgical schedule, preoperative anaesthesia record sheet, primary physicians, the anaesthetist responsible for the preoperative assessment and conducting the case and by communicating patients if required. Data were checked on daily basis for completeness and were entered to Epi info and analyzed using statistical package for social sciences (SPSS) version 20 software.Result: There were 64 causes of case cancellation. The commonest reasons for cancellation were overbooking of elective surgeries (33.13%).Conclusion: Preventable causes of case cancellation were the most prominent.

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