Stepaniak Pieter S, Mannaerts Guido H H, de Quelerij Marcel, de Vries Guus
Division of Operating Rooms and Anaesthesiology, St. Franciscus Hospital, Rotterdam, The Netherlands.
Anesth Analg. 2009 Apr;108(4):1249-56. doi: 10.1213/ane.0b013e318195e109.
The Operating Room Coordinator (ORC) is responsible for filling gaps in every operating room (OR) schedule. We have observed differences among the personalities of the four ORCs with regard to their willingness to agree to assume more risk concerning their daily planning. The hypothesis to be tested is that the relationship between the personality of each of the four ORCs and the risk an ORC is willing to take of cases running late affects OR efficiency.
In order to judge the personality of an ORC in relation to risk-taking in planning schedules, we applied the Zuckerman-Kuhlman Personality Questionnaire in our study. Seven anesthesiologists were asked to score every ORC on willingness to take risks in planning. To analyze which risk attitude creates more OR efficiency, the daily prognosis of the ORC compared with the actual OR program outcome was registered during a 5-mo period in 2006 and 2007. We analyzed whether, in the opinion of hospital management, the costs of reserving too much OR time balances with the costs of reserving too little OR time, and whether this result is consistent with the assignment of the management tasks of the ORC.
Seven anesthesiologists classified the four ORCs into the risk-averse group (n = 2) and the nonrisk-averse group (n = 2). The Zuckerman-Kuhlman Personality Questionnaire results for risk-seeking indicate that there is a difference in risk appreciation among the different ORCs. The main finding in our study is that the nonrisk-averse ORC plans to fill the gaps in more cases in the OR program than the risk-averse ORC does. The number of extra cases performed by the nonrisk-averse ORC as compared to a risk-averse ORC is 188 in 2006 and 174 in 2007. The average end-of-program-time per OR/day for the nonrisk-averse ORC is 34 min (+/-19 min, P = 0.0085) later than for the risk-averse ORC. We find that this hospital on average reserves more OR time for procedures than is actually required. The nonrisk-averse ORC takes more advantage of that extra OR time than the risk-averse ORC does by scheduling extra cases during office hours. The success of the nonrisk-averse ORC can be linked to the fact that there is usually time available due to this over-reserving.
The conclusion of this study is that a nonrisk-averse ORC creates significantly less unused OR capacity without a great chance of running ORs after regular working hours or canceling elective cases scheduled for surgery compared to a risk-averse ORC.
手术室协调员（ORC）负责填补每个手术室（OR）日程安排中的空白。我们观察到四位手术室协调员在日常规划中承担更多风险的意愿方面存在性格差异。有待检验的假设是，四位手术室协调员各自的性格与他们愿意承担手术延迟风险之间的关系会影响手术室效率。
为了判断手术室协调员在规划日程时与冒险倾向相关的性格，我们在研究中应用了祖克曼 - 库尔曼人格问卷。我们请七位麻醉师对每位手术室协调员在规划中承担风险的意愿进行评分。为了分析哪种风险态度能带来更高的手术室效率，我们记录了2006年和2007年5个月期间手术室协调员的每日预后情况，并与实际的手术室手术安排结果进行比较。我们分析了医院管理层认为预留过多手术室时间的成本与预留过少手术室时间的成本是否平衡，以及这一结果是否与手术室协调员的管理任务分配相一致。
七位麻醉师将四位手术室协调员分为风险厌恶组（n = 2）和非风险厌恶组（n = 2）。祖克曼 - 库尔曼人格问卷中关于寻求风险的结果表明，不同的手术室协调员在风险认知上存在差异。我们研究的主要发现是，与风险厌恶型手术室协调员相比，非风险厌恶型手术室协调员计划填补手术室手术安排中更多病例的空白。2006年，非风险厌恶型手术室协调员比风险厌恶型手术室协调员多安排的额外病例数为188例，2007年为174例。非风险厌恶型手术室协调员的手术室每天平均结束时间比风险厌恶型手术室协调员晚34分钟（±19分钟，P = 0.0085）。我们发现，这家医院平均为手术程序预留的手术室时间比实际需要的更多。非风险厌恶型手术室协调员比风险厌恶型手术室协调员更能利用这些额外的手术室时间，即在办公时间安排额外的病例。非风险厌恶型手术室协调员的成功可以归因于这样一个事实，即由于这种过度预留，通常会有可用的时间。
本研究的结论是，与风险厌恶型手术室协调员相比，非风险厌恶型手术室协调员在不增加正常工作时间后进行手术或取消预定手术择期病例的可能性的情况下，显著减少了未使用的手术室容量。
