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非手术室麻醉套房中的效率和调度:从患者满意度到增加手术室收入的影响:一种常见的(常识)方法。

Efficiency and scheduling in the nonoperating room anesthesia suite: implications from patient satisfaction to increased revenue operating room: a common (Dollars and Sense) approach.

机构信息

Department of Anesthesiology and Perioperative Medicine, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USA.

出版信息

Curr Opin Anaesthesiol. 2019 Aug;32(4):498-503. doi: 10.1097/ACO.0000000000000744.

Abstract

PURPOSE OF REVIEW

Although the NORA setting continues to outgrow the main operating room in cases, there are few studies addressing efficiency metrics, and even fewer studies addressing those of a single specialty outpatient gastroenterology facility. In order to capitalize on this growing trend, gastrointestinal endoscopies must be scheduled in a way that prevents lost potential revenue while maintaining patient convenience, comfort, safety, and satisfaction. By standardizing our scheduling for procedure block time among various endoscopists and converting our sedation practices from conscious sedation to solely Propofol sedation in a 4 : 1 CRNA to Anesthesiologist model, we increased revenue while maximizing physician efficiency and site utilization.

RECENT FINDINGS

The commonly used main operating room efficiency benchmarks cannot effectively be applied in NORA as these two locations have widely different procedure times, turn-around-times, and recovery times. In fact, procedures in gastrointestinal endoscopy suites can be completed in less time than a typical operating room takes for turnover.

SUMMARY

By adapting our sedation practices to solely Propofol sedation and by standardizing our procedural schedule times among all the endoscopists, we maximized the number of cases and revenue in our outpatient gastrointestinal endoscopy suite while increasing patient satisfaction through reduction in overall patient facility time and procedure to discharge time.

摘要

目的综述

尽管 NORA 环境下的手术量持续超过主手术室,但针对效率指标的研究很少,针对单一专科门诊胃肠病学设施的研究则更少。为了充分利用这一增长趋势,胃肠内窥镜检查的安排必须既能防止潜在收入损失,又能保持患者的便利、舒适、安全和满意度。通过在不同内镜医生之间为手术块时间制定标准化的时间表,并将镇静实践从清醒镇静改为仅在 4:1 麻醉护师与麻醉师模式下使用丙泊酚镇静,我们在最大限度地提高医生效率和场地利用率的同时增加了收入。

最新发现

常用的主手术室效率基准在 NORA 中无法有效应用,因为这两个位置的手术时间、周转时间和恢复时间差异很大。事实上,胃肠内窥镜检查室的手术可以在比典型手术室的交接时间更短的时间内完成。

总结

通过将镇静实践改为仅使用丙泊酚镇静,并在所有内镜医生之间标准化手术时间表,我们在增加患者满意度的同时,通过减少患者整体在院时间和从入院到出院的时间,使我们的门诊胃肠内窥镜检查室的病例数和收入最大化。

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