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麻醉控制时间对荷兰大学医学中心手术室排班的影响。

The influence of anesthesia-controlled time on operating room scheduling in Dutch university medical centres.

作者信息

van Veen-Berkx Elizabeth, Bitter Justin, Elkhuizen Sylvia G, Buhre Wolfgang F, Kalkman Cor J, Gooszen Hein G, Kazemier Geert

机构信息

Department of Operating Rooms, Erasmus University Medical Centre Rotterdam, Room Number: Hs-324, PO Box 2040, 3000 CA, Rotterdam, The Netherlands,

出版信息

Can J Anaesth. 2014 Jun;61(6):524-32. doi: 10.1007/s12630-014-0134-9. Epub 2014 Mar 6.

Abstract

BACKGROUND

Predicting total procedure time (TPT) entails several elements subject to variability, including the two main components: surgeon-controlled time (SCT) and anesthesia-controlled time (ACT). This study explores the effect of ACT on TPT as a proportion of TPT as opposed to a fixed number of minutes. The goal is to enhance the prediction of TPT and improve operating room scheduling.

METHODS

Data from six university medical centres (UMCs) over seven consecutive years (2005-2011) were included, comprising 330,258 inpatient elective surgical cases. Based on the actual ACT and SCT, the revised prediction of TPT was determined as SCT × 1.33. Differences between actual and predicted total procedure times were calculated for the two methods of prediction.

RESULTS

The predictability of TPT improved when the scheduling of procedures was based on predicting ACT as a proportion of SCT.

CONCLUSIONS

Efficient operating room (OR) management demands the accurate prediction of the times needed for all components of care, including SCT and ACT, for each surgical procedure. Supported by an extensive dataset from six UMCs, we advise grossing up the SCT by 33% to account for ACT (revised prediction of TPT = SCT × 1.33), rather than employing a methodology for predicting ACT based on a fixed number of minutes. This recommendation will improve OR scheduling, which could result in reducing overutilized OR time and the number of case cancellations and could lead to more efficient use of limited OR resources.

摘要

背景

预测总手术时间(TPT)涉及多个可变因素,包括两个主要组成部分:外科医生控制时间(SCT)和麻醉控制时间(ACT)。本研究探讨ACT作为TPT的一部分对TPT的影响,而非基于固定的分钟数。目的是提高TPT的预测能力并改善手术室排班。

方法

纳入来自六所大学医学中心(UMC)连续七年(2005 - 2011年)的数据,包括330,258例住院择期手术病例。根据实际的ACT和SCT,将TPT的修订预测值确定为SCT×1.33。针对两种预测方法计算实际总手术时间与预测总手术时间之间的差异。

结果

当根据ACT占SCT的比例来预测手术安排时,TPT的可预测性得到提高。

结论

高效的手术室(OR)管理需要准确预测每个手术过程中包括SCT和ACT在内的所有护理环节所需时间。在来自六个UMC的大量数据集支持下,我们建议将SCT增加33%以计入ACT(TPT的修订预测值 = SCT×1.33),而不是采用基于固定分钟数来预测ACT的方法。这一建议将改善手术室排班,可能减少手术室时间的过度使用以及病例取消的数量,并可能更有效地利用有限的手术室资源。

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