Journal article
Influence of parameter uncertainty on the tardiness of the start of a surgical case following a preceding surgical case performed by a different surgeon
Perioperative Care and Operating Room Management, Vol.13, pp.12-17
12/2018
DOI: 10.1016/j.pcorm.2018.11.001
Abstract
To-follow surgeons suffer from tardiness of start times due to preceding surgical cases in operating rooms (OR) taking longer than scheduled. Preceding cases take longer than their expected (mean) time not only because of process variability (e.g., different surgical first assist) but parameter uncertainty (e.g., surgeon has not previously performed the procedure at the hospital). Uncommon combinations of scheduled procedures occur frequently. We quantified Bayesian methods’ mitigation of the effect of parameter uncertainty on tardiness at a hospital. There were N = 7361 pairs of first and second cases of the day of different surgeons performed in the same OR and with the same sequence as that assigned as of 7 P.M. the day before surgery. For each pair, random OR times for the first case were generated from the posterior distribution incorporating surgical suite, year, estimated OR time from the surgeon and scheduler, and historical OR times, classified by combination of surgeon and scheduled procedure(s). The cases of a second surgeon that followed a preceding case with 0–3 historical OR times accounted for 21.1% (SE 1.2%) of the total tardiness and 17.1% (SE 0.9%) of cases. The pairwise ratios of total tardiness to cases equaled 1.233 (95% confidence interval 1.203–1.263). The calculations were repeated for cases with no historical data. The pairwise ratios averaged 1.223, not significantly different (P = 0.35). Without using a Bayesian method, instead of 21% of tardiness attributable to cases with few data, it would be nearly 100%. Therefore, the results predict the value of using a Bayesian method for estimating OR times at hospitals with case scheduled of uncommon procedures. Bayesian methods can be implemented with a spreadsheet (e.g., Excel worksheet) or a database table updated annually.
Details
- Title: Subtitle
- Influence of parameter uncertainty on the tardiness of the start of a surgical case following a preceding surgical case performed by a different surgeon
- Creators
- Franklin Dexter - Division of Management Consulting, Department of Anesthesia, University of Iowa, 200 Hawkins Drive, 6 JCP, Iowa City, Iowa, 52242, United StatesEmine Ozgur Bayman - Departments of Anesthesia and Biostatistics, University of Iowa, Iowa City, United StatesJuan Carlos Pattillo - Sección Cirugía Pediátrica, División de Cirugía, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, ChileEric S Schwenk - Department of Anesthesiology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, United StatesRichard H Epstein - Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami, Miami, United States
- Resource Type
- Journal article
- Publication Details
- Perioperative Care and Operating Room Management, Vol.13, pp.12-17
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.pcorm.2018.11.001
- ISSN
- 2405-6030
- eISSN
- 2405-6030
- Language
- English
- Date published
- 12/2018
- Academic Unit
- Anesthesia; Health Management and Policy; Biostatistics
- Record Identifier
- 9983806268402771
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