Agnoletti Vanni, Buccioli Matteo, Padovani Emanuele, Corso Ruggero M, Perger Peter, Piraccini Emanuele, Orelli Rebecca Levy, Maitan Stefano, Dell'amore Davide, Garcea Domenico, Vicini Claudio, Montella Teresa Maria, Gambale Giorgio
Department of Emergency, Anesthesia and Intensive Care Unit, Morgagni-Pierantoni Hospital, Forlì, Italy.
BMC Surg. 2013 Mar 11;13:7. doi: 10.1186/1471-2482-13-7.
European Healthcare Systems are facing a difficult period characterized by increasing costs and spending cuts due to economic problems. There is the urgent need for new tools which sustain Hospitals decision makers work. This project aimed to develop a data recording system of the surgical process of every patient within the operating theatre. The primary goal was to create a practical and easy data processing tool to give hospital managers, anesthesiologists and surgeons the information basis to increase operating theaters efficiency and patient safety.
The developed data analysis tool is embedded in an Oracle Business Intelligence Environment, which processes data to simple and understandable performance tachometers and tables. The underlying data analysis is based on scientific literature and the projects teams experience with tracked data. The system login is layered and different users have access to different data outputs depending on their professional needs. The system is divided in the tree profile types Manager, Anesthesiologist and Surgeon. Every profile includes subcategories where operators can access more detailed data analyses. The first data output screen shows general information and guides the user towards more detailed data analysis. The data recording system enabled the registration of 14.675 surgical operations performed from 2009 to 2011.
Raw utilization increased from 44% in 2009 to 52% in 2011. The number of high complexity surgical procedures (≥120 minutes) has increased in certain units while decreased in others. The number of unscheduled procedures performed has been reduced (from 25% in 2009 to 14% in 2011) while maintaining the same percentage of surgical procedures. The number of overtime events decreased in 2010 (23%) and in 2011 (21%) compared to 2009 (28%) and the delays expressed in minutes are almost the same (mean 78 min). The direct link found between the complexity of surgical procedures, the number of unscheduled procedures and overtime show a positive impact of the project on OR management. Despite a consistency in the complexity of procedures (19% in 2009 and 21% in 2011), surgical groups have been successful in reducing the number of unscheduled procedures (from 25% in 2009 to 14% in 2011) and overtime (from 28% in 2009 to 21% in 2011).
The developed project gives healthcare managers, anesthesiologists and surgeons useful information to increase surgical theaters efficiency and patient safety. In difficult economic times is possible to develop something that is of some value to the patient and healthcare system too.
由于经济问题，欧洲医疗体系正面临一个艰难时期，其特点是成本不断增加和开支削减。迫切需要新的工具来支持医院决策者的工作。该项目旨在开发一个记录手术室中每位患者手术过程的数据系统。主要目标是创建一个实用且易于处理的数据工具，为医院管理人员、麻醉师和外科医生提供信息基础，以提高手术室效率和患者安全性。
所开发的数据分析工具嵌入在甲骨文商业智能环境中，该环境将数据处理为简单易懂的性能转速表和表格。基础数据分析基于科学文献以及项目团队对跟踪数据的经验。系统登录是分层的，不同用户根据其专业需求可访问不同的数据输出。系统分为经理、麻醉师和外科医生三种配置文件类型。每个配置文件都包括子类别，操作人员可在其中访问更详细的数据分析。第一个数据输出屏幕显示一般信息，并引导用户进行更详细的数据分析。该数据记录系统记录了2009年至2011年期间进行的14675例外科手术。
原始利用率从2009年的44%提高到2011年的52%。某些科室高复杂性外科手术（≥120分钟）的数量有所增加，而其他科室则有所减少。非计划手术的数量有所减少（从2009年的25%降至2011年的14%），同时外科手术的百分比保持不变。与2009年（28%）相比，2010年（23%）和2011年（21%）的加班事件数量有所减少，以分钟表示的延迟时间几乎相同（平均78分钟）。手术复杂性、非计划手术数量和加班之间的直接联系表明该项目对手术室管理有积极影响。尽管手术复杂性保持一致（2009年为19%，2011年为21%），但外科团队成功减少了非计划手术的数量（从2009年的25%降至2011年的14%）和加班时间（从2009年的28%降至2011年的21%）。
所开发的项目为医疗管理人员、麻醉师和外科医生提供了有用信息，以提高手术室效率和患者安全性。在经济困难时期，也有可能开发出对患者和医疗系统有一定价值的东西。
