Adejumo A O, Adejumo P O
Department of Psychology, the Centre for West African Bioethics, College of Medicine, University of Ibadan, Nigeria.
Afr J Med Med Sci. 2009 Jun;38(2):163-71.
Operating rooms (OR) in hospitals represent big investments and must be utilized efficiently. Inaccurate scheduling of OR resources often results in delays of surgery or cancellations of procedures. These are costly to the patient, surgical team and hospital. Existing literatures in the OR management lack consensus on the method of evaluating management decisions from the perspectives of personnel or those affected by management decision-making processes. Eight key informant interviews were conducted. Also, 50 Operating Theatre Personnel (OTP), i.e., Surgeons, OR Nurses, Anaesthetists, and Executive Officers in the Nigeria's premier University Teaching Hospital were asked to complete a survey questionnaire concerning operating theatre resource allocation in the hospital. Five close-ended and 10 open-ended questions were used. (For example, how are the decisions to allocate OR resources in this hospital made?) Thematic analysis and descriptive statistics were done. The theoretical framework, accountability for reasonableness was applied. Forty-eight percent of the participants were ignorant of the framework guiding OR resource allocation. 54% of the respondents admitted the current mechanism for publicizing management decisions on OR resource allocation is ineffective. Another 50% of the respondents knew little about the mode of appealing against unfavourable allocation decisions. Participants' open ended responses revealed that hospital executives and a few consultant surgeons control the allocation of OR resources, with little recourse to OR personnel's concerns. If operating theatre stake holders are excluded in the planning, allocation and evaluation of OR resources, the efficiency required in surgical services would never be realized irrespective of the dexterity of the surgical team.
医院的手术室是重大投资,必须高效利用。手术室资源安排不当常常导致手术延误或手术取消。这对患者、手术团队和医院来说成本高昂。手术室管理方面的现有文献在从人员或受管理决策过程影响者的角度评估管理决策方法上缺乏共识。进行了八次关键信息人访谈。此外,还要求尼日利亚一流大学教学医院的50名手术室工作人员,即外科医生、手术室护士、麻醉师和行政官员,填写一份关于该医院手术室资源分配的调查问卷。使用了五个封闭式问题和10个开放式问题。(例如,该医院是如何做出手术室资源分配决策的?)进行了主题分析和描述性统计。应用了合理性问责的理论框架。48%的参与者对指导手术室资源分配的框架一无所知。54%的受访者承认当前公布手术室资源分配管理决策的机制无效。另有50%的受访者对针对不利分配决策提出申诉的方式知之甚少。参与者的开放式回答显示,医院管理人员和少数顾问外科医生控制着手术室资源的分配,很少考虑手术室工作人员的关切。如果在手术室资源的规划、分配和评估中排除手术室利益相关者,无论手术团队多么熟练,手术服务所需的效率都无法实现。