Institute of Health Care Organization Administration, College of Public Health, National Taiwan University, Taiwan.
J Eval Clin Pract. 2010 Oct;16(5):905-10. doi: 10.1111/j.1365-2753.2009.01213.x.
There is much research using statistical process control (SPC) to monitor surgical performance, including comparisons among groups to detect small process shifts, but few of these studies have included a stabilization process. This study aimed to analyse the performance of surgeons in operating room (OR) and set a benchmark by SPC after stabilized process.
The OR profile of 499 patients who underwent laparoscopic cholecystectomy performed by 16 surgeons at a tertiary hospital in Taiwan during 2005 and 2006 were recorded. SPC was applied to analyse operative and non-operative times using the following five steps: first, the times were divided into two segments; second, they were normalized; third, they were evaluated as individual processes; fourth, the ARL(0) was calculated;, and fifth, the different groups (surgeons) were compared. Outliers were excluded to ensure stability for each group and to facilitate inter-group comparison.
The results showed that in the stabilized process, only one surgeon exhibited a significantly shorter total process time (including operative time and non-operative time).
In this study, we use five steps to demonstrate how to control surgical and non-surgical time in phase I. There are some measures that can be taken to prevent skew and instability in the process. Also, using SPC, one surgeon can be shown to be a real benchmark.
有许多使用统计过程控制（SPC）来监测手术绩效的研究，包括对小组进行比较以检测微小的过程变化，但这些研究很少包括稳定化过程。本研究旨在分析手术室（OR）中外科医生的表现，并在稳定化过程后通过 SPC 设定基准。
记录了 2005 年至 2006 年期间在台湾一家三级医院接受腹腔镜胆囊切除术的 499 名患者的 OR 概况。使用以下五个步骤应用 SPC 分析手术和非手术时间：首先，将时间分为两段；其次，对其进行标准化；第三，将其评估为个体过程；第四，计算 ARL(0)；第五，比较不同组（外科医生）。排除异常值以确保每个组的稳定性并促进组间比较。
结果表明，在稳定化过程中，只有一名外科医生的总手术时间（包括手术时间和非手术时间）明显缩短。
在这项研究中，我们使用五个步骤来展示如何在第 I 阶段控制手术和非手术时间。可以采取一些措施来防止过程中的偏斜和不稳定。此外，使用 SPC，可以显示出一位外科医生是真正的基准。
