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常用手术室管理工具在减少手术日第一台手术延迟方面的成功:来自德国医院的证据。

Success of commonly used operating room management tools in reducing tardiness of first case of the day starts: evidence from German hospitals.

机构信息

Hohenheim University, Hohenheim Research Center for Innovation and Services, Stuttgart, Germany.

出版信息

Anesth Analg. 2012 Sep;115(3):671-7. doi: 10.1213/ANE.0b013e31825c0486. Epub 2012 Jun 22.

Abstract

BACKGROUND

One of the declared objectives of surgical suite management in Germany is to increase operating room (OR) efficiency by reducing tardiness of first case of the day starts. We analyzed whether the introduction of OR management tools by German hospitals in response to increasing economic pressure was successful in achieving this objective. The OR management tools we considered were the appointment of an OR manager and the development and adoption of a surgical suite governance document (OR charter). We hypothesized that tardiness of first case starts was less in ORs that have adopted one or both of these tools.

METHODS

Using representative 2005 survey data from 107 German anesthesiology departments, we used a Tobit model to estimate the effect of the introduction of an OR manager or OR charter on tardiness of first case starts, while controlling for hospital size and surgical suite complexity.

RESULTS

Adoption reduced tardiness of first case starts by at least 7 minutes (mean reduction 15 minutes, 95% confidence interval (CI): 7-22 minutes, P < 0.001).

CONCLUSION

Reductions in tardiness of first case starts figure prominently the objectives of surgical suite management in Germany. Our results suggest that the appointment of an OR manager or the adoption of an OR charter support this objective. For short-term decision making on the day of surgery, this reduction in tardiness may have economic implications, because it reduced overutilized OR time.

摘要

背景

德国外科手术室管理的既定目标之一是通过减少手术日第一台手术的延迟来提高手术室(OR)效率。我们分析了德国医院为应对经济压力的增加而采用手术室管理工具是否成功实现了这一目标。我们考虑的手术室管理工具是任命手术室经理以及制定和采用手术套房治理文件(手术室章程)。我们假设采用这些工具中的一种或两种工具的手术室,第一台手术的开始延迟会减少。

方法

使用来自 107 个德国麻醉科的具有代表性的 2005 年调查数据,我们使用 Tobit 模型来估计引入手术室经理或手术室章程对第一台手术开始延迟的影响,同时控制医院规模和手术套房复杂性。

结果

采用至少减少了第一台手术开始的延迟 7 分钟(平均减少 15 分钟,95%置信区间(CI):7-22 分钟,P < 0.001)。

结论

减少第一台手术开始的延迟是德国外科手术室管理的主要目标之一。我们的结果表明,任命手术室经理或采用手术室章程支持这一目标。对于手术当天的短期决策,这种延迟减少可能具有经济意义,因为它减少了过度利用的手术室时间。

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