Kodali Bhavani Shankar, Kim K Dennie, Flanagan Hugh, Ehrenfeld Jesse M, Urman Richard D
Harvard Medical School/Brigham and Women's Hospital, Boston, MA, USA.
J Med Syst. 2014 Feb;38(2):11. doi: 10.1007/s10916-014-0011-7. Epub 2014 Jan 28.
Realistic scheduling of operating room cases decreases costs, optimizes utilization and improves staff and patient satisfaction. Currently limited data exists to establish anesthesia-controlled time benchmarks based on specific subspecialty service. In this multicenter retrospective analysis of cases performed during a 53 month period at two large multispecialty academic institutions, data were retrieved from the perioperative information systems at each center. Both induction and emergence times were calculated. We then determined mean and median anesthesia controlled times based on each subspecialty service and compared them to previously published anesthesia-controlled time data. We obtained data on 104,184 cases at hospital A, and 122,560 cases at Hospital B. For all specialties at hospital A and hospital B, median induction time was 16.0 min and 17.0 min, emergence time was 14.0 and 8.0 min, and total anesthesia controlled time was 31.0 min and 27.0 min respectively. There was considerable variability among different surgical specialties deviating from the previously established 30 min benchmark. Subspecialties with lower total anesthesia controlled times in both centers were pain, general surgery, gynecology, plastic surgery and urology. Subspecialties with higher total anesthesia controlled times in both centers included cardiac surgery, neurosurgery, transplant and vascular. Cardiac surgery had the highest total time of 60 min and 50 min at Hospital A and B respectively. Individual specialty-specific anesthesia controlled times should be used for case scheduling and to benchmark anesthesia performance.
合理安排手术室病例可降低成本、优化资源利用并提高工作人员和患者满意度。目前，基于特定亚专业服务建立麻醉控制时间基准的数据有限。在对两家大型多专业学术机构在53个月期间进行的病例进行的多中心回顾性分析中，从每个中心的围手术期信息系统中检索数据。计算诱导时间和苏醒时间。然后，我们根据每个亚专业服务确定平均和中位数麻醉控制时间，并将其与先前公布的麻醉控制时间数据进行比较。我们在医院A获得了104,184例病例的数据，在医院B获得了122,560例病例的数据。对于医院A和医院B的所有专科，中位数诱导时间分别为16.0分钟和17.0分钟，苏醒时间分别为14.0分钟和8.0分钟，总麻醉控制时间分别为31.0分钟和27.0分钟。不同外科专科之间存在相当大的差异，偏离了先前确定的30分钟基准。两个中心总麻醉控制时间较低的亚专科是疼痛科、普通外科、妇科、整形外科和泌尿外科。两个中心总麻醉控制时间较高的亚专科包括心脏外科、神经外科、移植和血管外科。心脏外科在医院A和B的总时间最高，分别为60分钟和50分钟。应使用特定专科的麻醉控制时间来安排病例并衡量麻醉表现。
