Academic Surgery Unit, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Southmoor Road, Manchester, M23 9LT, UK.
Faculty of Biology, Medicine and Health, University of Manchester, Oxford Road, Manchester, M13 9PL, UK.
J Med Syst. 2018 Jul 20;42(9):160. doi: 10.1007/s10916-018-1015-5.
Operating theatres represent a significant cost burden for healthcare providers around the world. Theatre start time is widely acknowledged as an important target for efficiency savings. However, there is uncertainty surrounding the effectiveness of strategies to improve start time, and questions regarding the barriers to their implementation. We conducted a systematic review of bibliographic databases to identify primary research papers assessing the effect of interventions on theatre start time. Two hundred and nine papers were found from electronic literature search with 14 being included in the final review. Financial incentives, educational approaches, system-based techniques, communication, the 'golden patient' initiative and 'the productive operating theatre' scheme have all been shown to improve start time. However, questions remain over which is the most effective, the longevity of their effects and whether the results can be extrapolated beyond the context in which they were studied. We summarise the key approaches reported in the literature and identify areas for future research. This is of use to clinicians and hospital managers seeking to improve efficiency and achieve cost savings.
手术室是全球医疗保健提供者的重大成本负担。手术开始时间被广泛认为是提高效率节省成本的重要目标。然而，改善开始时间的策略的有效性存在不确定性，并且存在对其实施障碍的疑问。我们对文献数据库进行了系统回顾，以确定评估干预措施对手术室开始时间影响的原始研究论文。从电子文献搜索中发现了 209 篇论文，其中 14 篇被纳入最终综述。已经证明财务激励、教育方法、基于系统的技术、沟通、“黄金病人”倡议和“富有成效的手术室”计划都可以改善开始时间。然而，仍然存在疑问，即哪种方法最有效、其效果的持续时间以及结果是否可以推广到研究背景之外。我们总结了文献中报告的主要方法，并确定了未来研究的领域。这对寻求提高效率和节省成本的临床医生和医院管理人员很有用。
