Travis Elizabeth, Woodhouse Sarah, Tan Ruth, Patel Sandeep, Donovan Jason, Brogan Kit
Waikato Hospital, Hamilton, New Zealand
University of Sussex, UK.
BMJ. 2014 Dec 15;349:g7182. doi: 10.1136/bmj.g7182.
To assess the accuracy of surgeons and anaesthetists in predicting the time it will take them to complete an operation or procedure and therefore explain some of the difficulties encountered in operating theatre scheduling.
Single centre, prospective observational study.
Plastic, orthopaedic, and general surgical operating theatres at a level 1 trauma centre serving a population of about 370,000.
92 operating theatre staff including surgical consultants, surgical registrars, anaesthetic consultants, and anaesthetic registrars.
Participants were asked how long they thought their procedure would take. These data were compared with actual time data recorded at the end of the case.
Absolute difference between predicted and actual time.
General surgeons underestimated the time required for the procedure by 31 minutes (95% confidence interval 7.6 to 54.4), meaning that procedures took, on average, 28.7% longer than predicted. Plastic surgeons underestimated by 5 minutes (-12.4 to 22.4), with procedures taking an average of 4.5% longer than predicted. Orthopaedic surgeons overestimated by 1 minute (-16.4 to 14.0), with procedures taking an average of 1.1% less time than predicted. Anaesthetists underestimated by 35 minutes (21.7 to 48.7), meaning that, on average, procedures took 167.5% longer than they predicted. The four specialty mean time overestimations or underestimations are significantly different from each other (P=0.01). The observed time differences between anaesthetists and both orthopaedic and plastic surgeons are significantly different (P<0.05), but the time difference between anaesthetists and general surgeons is not significantly different.
The inability of clinicians to predict the necessary time for a procedure is a significant cause of delay in the operating theatre. This study suggests that anaesthetists are the most inaccurate and highlights the potential differences between specialties in what is considered part of the "anaesthesia time."
评估外科医生和麻醉医生预测完成一台手术或一项操作所需时间的准确性，从而解释手术室排班中遇到的一些困难。
单中心前瞻性观察性研究。
一家为约37万人口服务的一级创伤中心的整形、骨科和普通外科手术室。
92名手术室工作人员，包括外科顾问医生、外科住院医生、麻醉顾问医生和麻醉住院医生。
询问参与者他们认为自己的操作需要多长时间。将这些数据与病例结束时记录的实际时间数据进行比较。
预测时间与实际时间的绝对差值。
普通外科医生将操作所需时间低估了31分钟（95%置信区间为7.6至54.4），这意味着操作平均比预测时间长28.7%。整形外科医生低估了5分钟（-12.4至22.4），操作平均比预测时间长4.5%。骨科医生高估了1分钟（-16.4至14.0），操作平均比预测时间少1.1%。麻醉医生低估了35分钟（21.7至48.7），这意味着操作平均比他们预测的时间长167.5%。四个专科的平均时间高估或低估情况彼此有显著差异（P = 0.01）。麻醉医生与骨科医生和整形外科医生之间观察到的时间差异有显著差异（P < 0.05），但麻醉医生与普通外科医生之间的时间差异无显著差异。
临床医生无法预测一项操作所需的必要时间是手术室延误的一个重要原因。本研究表明麻醉医生的预测最不准确，并突出了各专科在“麻醉时间”的构成方面可能存在的差异。
