Operating Room Management In Klaipėda University Hospital: Prospective Analysis In 2009

2016 ◽  
Vol 26 (5) ◽  
pp. 114-119
Author(s):  
Renata Paškevičiūtė ◽  
Geda Klimavičiūtė
Keyword(s):  
Operating Room ◽  
Surgical Procedures ◽  
Surgical Procedure ◽  
Operating Rooms ◽  
Turnover Time ◽  
University Hospital ◽  
Time Variability ◽  
Procedure Time ◽  
High Turnover ◽  
Scheduled Time

Summary Background: Klaipeda University Hospital performs about 30000 surgical procedures every year. The operating room (OR) is a major production unit in hospital. The OR is very expensive to construct and to operate. The goal might be thought to be full utilization of all operating rooms during all hours that they are staffed and available for scheduling. Management is the ability to apply a diverse body of knowledge to accomplish planning, organizing, staffing, leading, and controling a work group. Methods: We decided accidentally to choose and to analyze OR utilization. We had analyzed central operating department consisting of 9 ORs with regularly scheduled time 8:00 AM to 4:00 PM (8 h), full staffed in 2009 four months period (78 workdays). Four months (78 workdays) of data were collected from the 9 operating rooms surveys. Holidays and weekends were excluded.The data was analyzed using “ Statistica” version 7.Results: There were performed 1982 surgical procedures (elective – 1807 (91,2%), urgent – 99 (5%), cancelled – 76 (3,8%)) during investigated period regularly scheduled time (8 h). Actually utilized OR time of all 9 ORs was 4648 h (82,76%), it was planned to work 5616 h. Our OR utilization was 82,76% during investigated period. Total under – utilized time was 968 h (17,36%). Surgeon estimated surgical procedure time was longer than actual surgical procedure time, variability of case duration between surgical teams was high. Turnover time mean duration was 28 min. Conclusions: Our study demonstrates that our central operating department have been worked efficiently (OR utilization was 82,76%, case cancellation rate was 3,8%, mean turnover time was 28 min, prolonged turnovers were less than 10%) in 2009 (four month period).

Causes and Effects of Inefficient Operating Room Flow during Working Hours in a University Hospital

2020 ◽  
Vol 103 (9) ◽  
pp. 897-903
Keyword(s):  
Operating Room ◽  
Elective Surgery ◽  
Tertiary Care ◽  
Working Hours ◽  
Turnover Time ◽  
University Hospital ◽  
Or Efficiency ◽  
Average Delay ◽  
First Case ◽  
Cancellation Rate

Background: Operating rooms (ORs) are major source of both hospitals’ revenue and expenses; hence, OR efficiency is not only essential, but challenging for providing high-quality care, whilst utilizing limited resources. Materials and Methods: A prospective, observational study was conducted in a tertiary care university hospital to identify both causes and effects of inefficient OR flow, including the rate of first case tardiness, time delays while patients are in room, turnover time, cancellation rate, and OR-overutilization. Patients scheduled for elective surgery between September 2014 and February 2015 were recruited. Results: Three thousand nine hundred sixty-five elective surgical cases were recruited. The rate of first case tardiness was 48%. The average delay time of the first case was 25±16.6 minutes, with the main cause being late arrivals of surgical teams (97.4%). The rate of time delay while the patients were in room, was 73.2%. This is being associated with both the surgical and the anesthesia teams (83%), as well as positioning and procedures-related to the general anesthesia. The delay in turnover time was 12.9% with an average of 32.3±23.3 minutes, with most common causes being swapping of cases between ORs (22.7%) and delays in transferring patients from the ward (21.7%). The cancellation rate was 11.8%, with General surgery having the highest rate (15.5%) due to insufficient OR time (26.2%). Sixty-four-point-eight percent of the operations continued after working hours, with an average of 121.7±106.1 minutes (range 4 to 670 minutes). Conclusion: The present study identified five process points of OR inefficiency in a university hospital, demonstrating that there are substantial opportunities for enhancement of OR efficiency. Keywords: Efficiency, Operating room, First case, Tardiness, Cancellation, Turnover time, Utilization

scholarly journals Experimental Setup Employed in the Operating Room Based on Virtual and Mixed Reality: Analysis of Pros and Cons in Open Abdomen Surgery

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
R. Galati ◽  
M. Simone ◽  
G. Barile ◽  
R. De Luca ◽  
C. Cartanese ◽  
...  
Keyword(s):  
Operating Room ◽  
Surgical Procedures ◽  
Open Abdomen ◽  
Mixed Reality ◽  
Operating Rooms ◽  
Experimental Setup ◽  
Operating Table ◽  
Remarkable Feature ◽  
Suggested Approach ◽  
Microsoft Hololens

Currently, surgeons in operating rooms are forced to focus their attention both on the patient’s body and on flat low-quality surgical monitors, in order to get all the information needed to successfully complete surgeries. The way the data are displayed leads to disturbances of the surgeon’s visuals, which may affect his performances, besides the fact that other members of the surgical team do not have proper visual tools able to aid him. The idea underlying this paper is to exploit mixed reality to support surgeons during surgical procedures. In particular, the proposed experimental setup, employed in the operating room, is based on an architecture that put together the Microsoft HoloLens, a Digital Imaging and Communications in Medicine (DICOM) player and a mixed reality visualization tool (i.e., Spectator View) developed by using the Mixed Reality Toolkit in Unity with Windows 10 SDK. The suggested approach enables visual information on the patient’s body as well as information on the results of medical screenings to be visualized on the surgeon’s headsets. Additionally, the architecture enables any data and details to be shared by the team members or by external users during surgical operations. The paper analyses in detail advantages and drawbacks that the surgeons have found when they wore the Microsoft HoloLens headset during all the ten open abdomen surgeries conducted at the IRCCS Hospital “Giovanni Paolo II” in the city of Bari (Italy). A survey based on Likert scale demonstrates how the use of the suggested tools can increase the execution speed by allowing multitasking procedures, i.e., by checking medical images at high resolution without leaving the operating table and the patient. On the other hand, the survey also reveals an increase in the physical stress and reduced comfort due to the weight of the Microsoft HoloLens device, along with drawbacks due to the battery autonomy. Additionally, the survey seems to encourage the use of DICOM Viewer and Spectator View both for surgical education and for improving surgery outcomes. Note that the real use of the conceived platform in the operating room represents a remarkable feature of this paper, since most if not all the studies conducted so far in literature exploit mixed reality only in simulated environments and not in real operating rooms. In conclusion, the study clearly highlights that, despite the challenges required in the forthcoming years to improve the current technology, mixed reality represents a promising technique that will soon enter the operating rooms to support surgeons during surgical procedures in many hospitals across the world.

scholarly journals Factors Affecting Hand Surgeon Operating Room Turnover Time

Hand ◽  
2016 ◽  
Vol 11 (4) ◽  
pp. 489-494 ◽  
Author(s):  
Michael B. Gottschalk ◽  
Richard M. Hinds ◽  
Raghuveer C. Muppavarapu ◽  
Kenneth Brock ◽  
Anthony Sapienza ◽  
...  
Keyword(s):  
Operating Room ◽  
Surgical Procedure ◽  
Hand Surgery ◽  
Turnover Time ◽  
Factors Affecting ◽  
Hand Surgeon ◽  
Surgery Patient ◽  
Significant Difference ◽  
Patient Health ◽  
Procedure Type

Background: The purpose of this study was to determine the factors that affect hand surgeon operating room (OR) turnover time. We hypothesized that surgeon presence in the OR, decreased American Society of Anesthesiologists (ASA) class, smaller case type, and earlier case time, as well as other factors, decreased OR turnover time. Methods: A total of 685 hand surgery cases performed by 5 attending hand surgeons between September 2013 and December 2014 were identified. Turnover time, patient comorbidities (ASA class), surgeon, prior OR surgical procedure, current OR surgical procedure, location of the surgery (ambulatory surgical center [ASC] vs orthopedic specialty hospital [OSH]), time of surgery, and order of OR cases were recorded. The effect of surgeon routine variables, OR case factors, and patient health status on OR turnover was analyzed. Results: Turnover time was significantly shorter in cases where the surgeon remained in the OR during turnover (27.5 minutes vs 30.4 minutes) and when the surgeon incentivized OR staff (24 minutes vs 29 minutes). The ASC was found to have shorter turnover times than the OSH (27.9 minutes vs 36.4 minutes). In addition, ASA class, type of prior OR procedure, type of current OR procedure, and case order all significantly affected turnover time. Comparison of OR turnover time among the 5 surgeons revealed a statistically significant difference at the OSH but not at the ASC. Conclusion: OR turnover time is significantly affected by surgeon routine, location of surgery, patient ASA class, procedure type, and case order. Interestingly, the effect of hand surgeon routine on OR turnover time may be amplified at an academic OSH versus an ASC.

scholarly journals Implementing, Connecting, and Evaluating a Standard-Based Integrated Operating Room within a German University Hospital

ACI Open ◽  
2018 ◽  
Vol 02 (01) ◽  
pp. e10-e20
Author(s):  
Raluca Dees ◽  
Angela Merzweiler ◽  
Gerd Schneider ◽  
Martin Kasparick ◽  
Lars Mündermann ◽  
...  
Keyword(s):  
Iterative Method ◽  
Operating Room ◽  
Medical Devices ◽  
Clinical Relevance ◽  
Additional Data ◽  
Operating Rooms ◽  
University Hospital ◽  
Human Machine Interfaces ◽  
It Systems ◽  
Integrated Operating Room

Background Digital operating rooms (ORs), when optimally designed and integrated, can reduce the complexity of the surgery suite. However, many integrated ORs are effectively isolated from other IT systems in the hospital because there is little or no connectivity with them. Within the German flagship project OR.NET, concepts and components were developed for a standard-based connection of the OR with hospital IT systems. Objectives The aim of this work was to implement and evaluate OR.NET concepts and components within the existing IT landscape of a German university hospital. This article describes and evaluates the implemented architecture and processes for connecting a demo OR to existing hospital IT systems at Heidelberg University Hospital. Methods For the design, establishment, and evaluation of standard-based connections of the demo OR with hospital IT systems, the iterative method “Design and Creation” with four iterations was applied. Results A generic and a concrete architecture for several standard-based connection concepts of the demo OR were developed. Furthermore, the concrete architecture was implemented and evaluated for its technical and clinical relevance. The main benefits of the project were the establishment of basic requisites for improving the efficiency within the OR, easier operation of medical devices as a result of harmonized human–machine interfaces, and providing additional data for improving healthcare. Conclusion OR.NET concepts for a standard-based connection of the OR with hospital IT systems have proven to be promising. They can serve as a reference for further integration scenarios in other hospitals.

scholarly journals Use of the surgical safety checklist in the operating room: Operating room nurses’ perspectives

2019 ◽  
Vol 35 (3) ◽  
Author(s):  
Oznur Gurlek Kisacik ◽  
Yeliz Cigerci
Keyword(s):  
Operating Room ◽  
Operating Rooms ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Cross Sectional ◽  
Team Collaboration ◽  
Surgical Safety Checklist ◽  
Surgical Safety ◽  
Creative Commons ◽  
Operating Room Nurses

Objective: To determine the opinions of operating room nurses towards the Surgical Safety ChecklistTR (SSCTR) and to determine applications for using SSCTR in operating rooms. Methods: This descriptive and cross-sectional study was conducted with 102 nurses working in the operating rooms of a state hospital and a university hospital in the Afyonkarahisar province. Descriptive statistics method were used for data analysis. Results: It was found that all operating room nurses knew the SSCTR and that they had a positive opinion regarding the necessity of the SSCTR. However, most of the participants stated that the SSCTR was not applied effectively in the operating room. Conclusion: The results obtained from the study show that changes focusing on the development of a culture of patient safety (PS) and team collaboration in operating rooms must be made in order to apply SSCTR consistently and properly. doi: https://doi.org/10.12669/pjms.35.3.29 How to cite this:Kisacik OG, Cigerci Y. Use of the surgical safety checklist in the operating room: Operating room nurses’ perspectives. Pak J Med Sci. 2019;35(3):---------. doi: https://doi.org/10.12669/pjms.35.3.29 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Effective operating room (OR) utilization by performing low-complex surgical procedures during the 2020 corona pandemic

2021 ◽  
Author(s):  
Thomas Vogel ◽  
Dina Schippers ◽  
Balqees Aldarweesh ◽  
Ilaria Pergolini ◽  
Martina Stollreiter ◽  
...  
Keyword(s):  
Operating Room ◽  
Surgical Procedures ◽  
Central Venous Access ◽  
Venous Access ◽  
University Hospital ◽  
Group 12 ◽  
Grade Ii ◽  
Complex Surgical Procedures ◽  
Oncologic Treatment ◽  
Low Complex

Abstract Purpose The SARS-CoV-2 pandemic has almost stopped all elective surgical treatment throughout the world. As operating room (OR) capacities are reduced everywhere to ensure availability of intensive care capacities, especially low-complex surgical procedures are often postponed. These include totally implantable central-venous access ports which are important for the oncologic treatment of cancer patients. Methods In our study, we investigated the potential of an outpatient surgical centre (OSC) in terms of workflow effectiveness compared to the central operating room complex (COR) of a university hospital using low-complex surgical procedures as an example. Data of 524 consecutive patients who received a Port-a-cath procedure (422 implantations (80.5%) and 102 explantations (19.5%)) in our department between February 2019 and February 2020 were evaluated. Results A total of 277 patients were operated in outpatient surgical centre (OSC), and 247 patients received the procedure in the central OR (COR) complex. Grade II and III complications according to the Clavien–Dindo classification occurred in 5.2% (OSC) and 7.3% (COR) of patients. Incision-to-suture time was significantly quicker in the OSC group (36 vs. 42 min., p < 0.032). Total OR time (01:08 vs. 01:20 h) and preparation-to-incision time were also shorter in the OSC group (12 vs. 17 min., p < 0.002). Conclusion In order to ensure effective OR utilization especially in times of the corona pandemic, the use of smaller decentralized OR units, e.g., outpatient surgical centres, for performing low-complex surgical cases is beneficial. Our study revealed shorter total OR and preparation-to-incision times.

Predicting Patient Nonappearance for Surgery as a Scheduling Strategy to Optimize Operating Room Utilization in a Veterans' Administration Hospital

2006 ◽  
Vol 104 (4) ◽  
pp. 826-834 ◽  
Author(s):  
Marc D. Basson ◽  
Timothy W. Butler ◽  
Harish Verma
Keyword(s):  
Operating Room ◽  
Surgical Procedures ◽  
Turnover Time ◽  
Veterans Administration ◽  
Clinical Procedures ◽  
First Case ◽  
Patient Noncompliance ◽  
Administration Hospital ◽  
Physician Patient ◽  
Improve Patient

Background Previous attempts at improving operating room utilization have generally emphasized more accurate scheduling, starting the first case on time, and reducing turnover time. Surgical case cancellations have largely been ignored except for recommendations for preoperative screening and good physician-patient communication to improve patient compliance. Methods A retrospective review of operating room records was initially used to identify reasons for surgical cancellations. This was followed by a retrospective stratified case-control study of patient records to identify preexisting factors that predict the failure of patients to appear for surgical procedures as scheduled. Factors assessed included demographics, type of surgical procedure, compliance with previous healthcare visits, substance abuse, mental illness, travel distance, and neurologic problems. Results The authors reviewed their operating room utilization and found patient nonappearance rates to be a substantial source of surgical cancellations. Furthermore, multivariate analysis demonstrated that patient nonappearance could be strongly predicted from patient noncompliance with clinic visits and other clinical procedures without reference to the other variables assessed. Further analysis of data from an independent sample of patients confirmed this observation. Conclusions Noncompliance with hospital visits for surgical procedures can be predicted from noncompliance with other healthcare encounters. Surgical procedures for previously noncompliant patients should be booked at the end of the operating room day, when the cancellation is least likely to interfere with operating room flow.

Risk of Sharp Device–Related Blood and Body Fluid Exposure in Operating Rooms

2008 ◽  
Vol 29 (12) ◽  
pp. 1139-1148 ◽  
Author(s):  
Douglas J. Myers ◽  
Carol Epling ◽  
John Dement ◽  
Debra Hunt
Keyword(s):  
Blood Loss ◽  
Surgical Procedures ◽  
Body Fluid ◽  
Operating Rooms ◽  
University Hospital ◽  
Operating Room Personnel ◽  
Surgical Equipment ◽  
Glove Perforation ◽  
Estimated Blood Loss ◽  
Duration Of Surgery

Objective.The risk of percutaneous blood and body fluid (BBF) exposures in operating rooms was analyzed with regard to various properties of surgical procedures.Design.Retrospective cohort study.Setting.A single university hospital.Methods.All surgical procedures performed during the period 2001–2002 (n = 60,583) were included in the analysis. Administrative data were linked to allow examination of 389 BBF exposures. Stratified exposure rates were calculated; Poisson regression was used to analyze risk factors. Risk of percutaneous BBF exposure was examined separately for events involving suture needles and events involving other device types.Results.Operating room personnel reported 6.4 BBF exposures per 1,000 surgical procedures (2.6 exposures per 1,000 surgical hours). Exposure rates increased with an increase in estimated blood loss (17.5 exposures per 1,000 procedures with 501–1,000 cc blood loss and 22.5 exposures per 1,000 procedures with >1,000 cc blood loss), increased number of personnel ever working in the surgical field (20.5 exposures per 1,000 procedures with 15 or more personnel ever in the field), and increased surgical procedure duration (13.7 exposures per 1,000 procedures that lasted 4–6 hours, 24.0 exposures per 1,000 procedures that lasted 6 hours or more). Associations were generally stronger for suture needle–related exposures.Conclusions.Our results support the need for prevention programs that are targeted to mitigate the risks for BBF exposure posed by high blood loss during surgery (eg, use of blunt suture needles and a neutral zone for passing surgical equipment) and prolonged duration of surgery (eg, double gloving to defend against the risk of glove perforation associated with long surgery). Further investigation is needed to understand the risks posed by lengthy surgical procedures.

scholarly journals Measuring quality indicators in the operating room: cleaning and turnover time

2011 ◽  
Vol 19 (5) ◽  
pp. 1239-1246 ◽  
Author(s):  
Marli de Carvalho Jericó ◽  
Márcia Galan Perroca ◽  
Vivian Colombo da Penha
Keyword(s):  
Operating Room ◽  
Quality Indicators ◽  
Descriptive Study ◽  
Turnover Time ◽  
The Other ◽  
University Hospital ◽  
Work Process ◽  
Use Of Resources ◽  
Kaplan Meier ◽  
Pearson's Correlation

This exploratory-descriptive study was carried out in the Surgical Center Unit of a university hospital aiming to measure time spent with concurrent cleaning performed by the cleaning service and turnover time and also investigated potential associations between cleaning time and the surgery's magnitude and specialty, period of the day and the room's size. The sample consisted of 101 surgeries, computing cleaning time and 60 surgeries, computing turnover time. The Kaplan-Meier method was used to analyze time and Pearson's correlation to study potential correlations. The time spent in concurrent cleaning was 7.1 minutes and turnover time was 35.6 minutes. No association between cleaning time and the other variables was found. These findings can support nurses in the efficient use of resources thereby speeding up the work process in the operating room.

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