Fong Abigail J, Smith Meghan, Langerman Alexander
University of Chicago Operative Performance Research Institute, Chicago, Illinois; Pritzker School of Medicine, University of Chicago, Chicago, Illinois.
University of Chicago Operative Performance Research Institute, Chicago, Illinois; Department of Surgery, Section of Otolaryngology-Head and Neck Surgery, University of Chicago, Chicago, Illinois.
J Surg Res. 2016 Aug;204(2):371-383. doi: 10.1016/j.jss.2016.04.054. Epub 2016 Apr 29.
In the changing health care environment, health systems, hospitals, and health care providers must focus on improving efficiency to meet an increasing demand for high-quality, low-cost health care. Much has been written about strategies and efforts to improve efficiency in the perioperative periods, yet the time when the patient is in the operating room-the intraoperative period-has received less attention. Yet, this is the period in which surgeons may have the most influence.
Systematically review published efforts to improve intraoperative efficiency; assess the outcomes of these efforts, and propose standardized reporting of future studies.
A total of 39 studies were identified that met inclusion criteria. These divided naturally into small (single operative team), medium (multi-operative team), and large (institutional) interventions. Most studies used time or money as their metric for efficiency, though others were used as well.
There is substantial opportunity to enhance operating room efficiency during the intraoperative period. Surgeons may have a particular role in procedural efficiency, which has been relatively unstudied. Common themes were standardizing tasks, collecting and using actionable data, and maintaining effective team communication.
在不断变化的医疗环境中，卫生系统、医院和医疗服务提供者必须专注于提高效率，以满足对高质量、低成本医疗服务日益增长的需求。关于围手术期提高效率的策略和努力已有大量著述，但患者在手术室的时间——术中阶段——却较少受到关注。然而，这正是外科医生可能最具影响力的阶段。
系统回顾已发表的提高术中效率的努力；评估这些努力的结果，并提出未来研究的标准化报告。
共确定了39项符合纳入标准的研究。这些研究自然分为小型（单个手术团队）、中型（多个手术团队）和大型（机构性）干预措施。大多数研究使用时间或金钱作为效率指标，不过也使用了其他指标。
在术中阶段提高手术室效率有很大机会。外科医生在手术效率方面可能具有特殊作用，而这方面相对较少被研究。常见主题包括任务标准化、收集和使用可操作的数据以及保持有效的团队沟通。
