Journal article
Tardiness of starts of surgical cases is not substantively greater when the preceding surgeon in an operating room is of a different versus the same specialty
Journal of Clinical Anesthesia, Vol.53, pp.20-26
03/2019
DOI: 10.1016/j.jclinane.2018.09.027
PMID: 30290278
Abstract
Switching from one specialty to another increases mean turnover times (i.e., interval between the exit and entrance of consecutive patients in an operating room [OR]). We estimate the effect on the mean tardiness of to-follow surgeons from following another surgeon of a different versus same specialty. Tardiness of a case's start time refers to the number of minutes the patient enters the OR later than scheduled; tardiness is 0 min if the patient enters early. Tardiness cause surgeon waiting. There are multiple causes of tardiness, but, most often, the preceding case(s) took longer than estimated. 10-year historical cohort study with all surgical cases performed during regular workdays. Large teaching hospital. Estimated OR end times were calculated using a Bayesian method. Because tardiness is influenced by the estimated case start time (i.e., later starting cases have greater tardiness), tardiness values were adjusted to a 12 noon start time for the 2nd surgeon. The cases of to-follow surgeons in ORs had mean tardiness of 45.1 (SE 0.6) min. When the to-follow surgeon in the OR was of a different versus the same specialty from the first surgeon, the mean turnover time was 7.3 (0.4) min longer (P < 0.00001). However, the mean tardiness was not significantly affected (0.1 min, 95% confidence interval [CI] −2.7 to 3.0 min; P = 0.93). In comparison, if one or more of the preceding cases in an OR was an add-on case, the increase in mean tardiness was 35 min (95% CI 28 to 43 min; P < 0.00001). OR managers can assure surgeons with afternoon starts that following a surgeon of a different specialty generally will not increase their waiting time. Case scheduling should focus on reducing over-utilized OR time and thus the hours that anesthesiologists and nurses work late. •We evaluated mean tardiness of to-follow surgeons in operating rooms following surgeons of different specialties.•The mean tardiness was no greater when 2 specialties were involved (mean 0.1 min; P = 0.93).•Surgeons with afternoon starts can be assured that following a surgeon of another specialty generally does not increase waiting time.
Details
- Title: Subtitle
- Tardiness of starts of surgical cases is not substantively greater when the preceding surgeon in an operating room is of a different versus the same specialty
- Creators
- Franklin Dexter - Division of Management Consulting, Department of Anesthesia University of Iowa, Iowa City, IA, United States of AmericaRichard H Epstein - Department of Anesthesiology, Pain Management and Perioperative Medicine, University of Miami, Miami, FL, United States of AmericaEric S Schwenk - Department of Anesthesiology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, United States of America
- Resource Type
- Journal article
- Publication Details
- Journal of Clinical Anesthesia, Vol.53, pp.20-26
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.jclinane.2018.09.027
- PMID
- 30290278
- ISSN
- 0952-8180
- eISSN
- 1873-4529
- Language
- English
- Date published
- 03/2019
- Academic Unit
- Health Management and Policy; Anesthesia
- Record Identifier
- 9983806381402771
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