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外科手术流程数据基准计划中进入前后的手术室效率

Operating Room Efficiency before and after Entrance in a Benchmarking Program for Surgical Process Data.

作者信息

Pedron Sara, Winter Vera, Oppel Eva-Maria, Bialas Enno

机构信息

Helmholtz Zentrum München, Institute for Health Economics and Health Care Management, Ingolstädter Landstraße 1, 85764, Neuherberg, DE, Germany.

Department of Political Science and Public Management, University of Southern Denmark, Campusvej 55, 5230, Odense, DK, Denmark.

出版信息

J Med Syst. 2017 Aug 23;41(10):151. doi: 10.1007/s10916-017-0798-0.

Abstract

Operating room (OR) efficiency continues to be a high priority for hospitals. In this context the concept of benchmarking has gained increasing importance as a means to improve OR performance. The aim of this study was to investigate whether and how participation in a benchmarking and reporting program for surgical process data was associated with a change in OR efficiency, measured through raw utilization, turnover times, and first-case tardiness. The main analysis is based on panel data from 202 surgical departments in German hospitals, which were derived from the largest database for surgical process data in Germany. Panel regression modelling was applied. Results revealed no clear and univocal trend of participation in a benchmarking and reporting program for surgical process data. The largest trend was observed for first-case tardiness. In contrast to expectations, turnover times showed a generally increasing trend during participation. For raw utilization no clear and statistically significant trend could be evidenced. Subgroup analyses revealed differences in effects across different hospital types and department specialties. Participation in a benchmarking and reporting program and thus the availability of reliable, timely and detailed analysis tools to support the OR management seemed to be correlated especially with an increase in the timeliness of staff members regarding first-case starts. The increasing trend in turnover time revealed the absence of effective strategies to improve this aspect of OR efficiency in German hospitals and could have meaningful consequences for the medium- and long-run capacity planning in the OR.

摘要

手术室效率一直是医院的高度优先事项。在这种背景下,基准化的概念作为提高手术室绩效的一种手段,其重要性日益凸显。本研究的目的是调查参与手术过程数据的基准化和报告计划是否以及如何与手术室效率的变化相关联,手术室效率通过原始利用率、周转时间和首例手术延迟来衡量。主要分析基于德国医院202个外科科室的面板数据,这些数据来自德国最大的手术过程数据库。采用了面板回归建模。结果显示,参与手术过程数据的基准化和报告计划没有明显且一致的趋势。在首例手术延迟方面观察到最大的趋势。与预期相反,参与期间周转时间总体呈上升趋势。对于原始利用率,无法证明有明显且具有统计学意义的趋势。亚组分析揭示了不同医院类型和科室专业在效果上的差异。参与基准化和报告计划,从而获得可靠、及时且详细的分析工具以支持手术室管理,似乎尤其与工作人员在首例手术开始时的及时性提高相关。周转时间的上升趋势表明德国医院缺乏提高手术室效率这一方面的有效策略,并且可能对手术室的中长期容量规划产生重大影响。

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