Nuffield Department of Anaesthetics, John Radcliffe Hospital, Oxford, UK.
J Health Organ Manag. 2009;23(5):554-67. doi: 10.1108/14777260910984032.
This paper sets out to investigate whether demand for gynaecological theatre time could be described in terms of the time required to undertake elective operations booked for surgery, and so help match the capacity to this.
DESIGN/METHODOLOGY/APPROACH: A questionnaire assessed the estimates for total operation time for seven common operations, sent to surgeons, anaesthetists and nursing staff in one tertiary referral and one district general hospital (total 49 staff; response rate 58 per cent), and estimates were obtained from theatre computer logs. Average timings for each operation were then applied to cases added from clinics to the waiting list at the district general, to yield the mean demand for elective surgery, and were also applied to emergencies to estimate emergency workload. Finally these demand estimates were compared with the theatre capacity available.
The paper found no difference between the estimates of the three staff groups or between these and the theatre logs (p = 0.669), nor did it find that estimates differed between the two centers (p = 0.628). Including emergencies, the mean (95 per cent confidence intervals) demand at the district general was 2438 (1952-2924) min/week.
RESEARCH LIMITATIONS/IMPLICATIONS: Although the paper modelled the variation in demand using the relevant variation in operation times, any additional variation caused by differences in booking rates from clinics over time was not nodelled. The minimum period over which data should be collected was not established.
The paper finds that the existing capacity of 1680 min/week did not match these needs and, unless it was increased, a rise in waiting lists was predictable.
ORIGINALITY/VALUE: The paper concludes that time estimates for scheduled operations can be better used to assess the need for surgical operating capacity than current measures of demand or capacity.
本文旨在探讨是否可以根据预约手术的择期手术所需时间来描述妇科手术室时间的需求,从而帮助与之匹配。
设计/方法/途径:一项问卷调查了三位分别来自一家三级转诊医院和一家地区综合医院的外科医生、麻醉师和护士,评估了七种常见手术的总手术时间估计值(共 49 名工作人员;回应率为 58%),并从手术室计算机日志中获取了估计值。然后,将每个手术的平均时间应用于从诊所添加到地区综合医院等候名单的病例,得出择期手术的平均需求,并将其应用于急诊以估计急诊工作量。最后,将这些需求估计与手术室的可用容量进行比较。
该论文发现三组工作人员的估计值之间没有差异,也与手术室日志中的数据没有差异(p=0.669),而且两组中心之间的估计值也没有差异(p=0.628)。包括急诊在内,地区综合医院的平均(95%置信区间)需求为 2438(1952-2924)分钟/周。
研究局限性/影响:尽管该论文使用相关手术时间的变化来模拟需求的变化,但未对随时间推移来自诊所的预订率差异造成的任何额外变化进行建模。没有确定应该收集数据的最短时间周期。
该论文发现,现有的 1680 分钟/周的容量无法满足这些需求,除非增加容量,否则等待名单的增加是可以预测的。
原创性/价值:该论文的结论是,与当前衡量需求或容量的方法相比,计划手术的时间估计值可以更好地用于评估手术能力的需求。