Krieg H, Schröder T, Grosse J, Hensel M, Volk T, von Heymann C, Bauer K, Bock R-W, Spies C D
Klinik für Anästhesiologie und operative Intensivmedizin, Campus Charité Mitte und Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Berlin.
Anaesthesist. 2007 Aug;56(8):812-9. doi: 10.1007/s00101-007-1205-x.
Induction areas (IA) can lead to more efficient operating sessions through shortening the changeover time between patients. To date IAs have always required additional staff members, whose cost was only partly covered by improvements in productivity. The objective of this project was to demonstrate that a reduction in non-operative time through a newly introduced induction area can be achieved without a need for extra personnel.
Non-operative time in 5,963 ENT, orthopedic and cardiac surgical patients from 8 operating theatres were studied for 1 year before and 1 year after the introduction of an induction area. The non-operative time was defined as the time between the end of surgical procedures in one operation and the start of surgical procedures in the next, within regular working hours. Through reallocation of anesthetic nursing and medical staff it was possible to introduce the induction area without increasing staff numbers.
Non-operative time was significantly reduced from 20 min (range 10-30 min) to 14 min (5-25 min). Subgroup analysis showed significant reductions in all specialities: from 10 min (2.5-20 min) to 5 min (0-20 min) in 1,240 cardiac surgical patients, 25 min (20-35 min) to 15 min (5-25 min) in 2,433 ENT patients and 20 min (10-30 min) to 10 min (0-20 min) in 2,290 orthopedic patients. There were no critical incidents attributable to patient handover.
An induction area can be established and can reduce non-operative time and improve operation theatre throughput without the need for extra personnel. The efficiency of these measures will be increased when the relevant surgical organizational measures are taken to adjust to the faster anesthesiology workflow. The induction area does not lead to a higher rate of critical incidents. To what extent the induction area can be used for structured training of doctors and nurses, remains to be investigated.
诱导区（IA）可通过缩短患者之间的转换时间来提高手术效率。迄今为止，诱导区一直需要额外的工作人员，其成本仅部分由生产率的提高所覆盖。本项目的目的是证明通过新引入的诱导区可以减少非手术时间，而无需额外的人员。
对8个手术室的5963例耳鼻喉科、骨科和心脏外科患者在引入诱导区之前1年和之后1年的非手术时间进行了研究。非手术时间定义为在正常工作时间内，一台手术的外科手术结束至下一台手术的外科手术开始之间的时间。通过重新分配麻醉护理和医务人员，在不增加工作人员数量的情况下引入了诱导区。
非手术时间从20分钟（范围10 - 30分钟）显著减少至14分钟（5 - 25分钟）。亚组分析显示所有专科均有显著减少：1240例心脏外科患者从10分钟（2.5 - 20分钟）降至5分钟（0 - 20分钟），2433例耳鼻喉科患者从25分钟（20 - 35分钟）降至15分钟（5 - 25分钟），2290例骨科患者从20分钟（10 - 30分钟）降至10分钟（0 - 20分钟）。没有因患者交接导致的严重事件。
可以建立诱导区，且无需额外人员即可减少非手术时间并提高手术室效率。当采取相关的手术组织措施以适应更快的麻醉工作流程时，这些措施的效率将得到提高。诱导区不会导致更高的严重事件发生率。诱导区在多大程度上可用于医生和护士的结构化培训，仍有待研究。
