Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington, USA.
Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, USA.
Otolaryngol Head Neck Surg. 2019 Nov;161(5):787-795. doi: 10.1177/0194599819864319. Epub 2019 Jul 23.
To examine if attending surgeon presence at the preinduction briefing is associated with a shorter time to incision.
Retrospective cohort study and survey.
Tertiary academic medical center.
A retrospective cohort study was conducted of 22,857 operations by 141 attending surgeons across 12 specialties between August 3, 2016, and June 21, 2018. The independent variable was attending surgeon presence at the preinduction briefing. Linear regression models compared time from room entry to incision overall, by service line, and by surgeon. We hypothesized a shorter time to incision when the attending surgeon was present and a larger effect for cases with complex surgical equipment or positioning. A survey was administered to evaluate attending surgeons' perceptions of the briefing, with a response rate of 68% (64 of 94 attending surgeons).
Cases for which the attending surgeon was present at the preinduction briefing had a statistically significant yet operationally minor reduction in mean time to incision when compared with cases when the attending surgeon was absent. After covariate adjustment, the mean time to incision was associated with an efficiency gain of 1.8 ± 0.5 minutes (mean ± SD; < .001). There were no statistically significant differences in the subgroups of complex surgical equipment and complex positioning or in secondary analysis comparing service lines. The surgeon was the strongest confounding variable. Survey results demonstrated mild support: 55% of attending surgeons highly prioritized attending the preinduction briefing.
Attending surgeon presence at the preinduction briefing has only a minor effect on efficiency as measured by time to incision.
探讨手术医生是否参加术前介绍会是否与切口时间缩短有关。
回顾性队列研究和调查。
三级学术医疗中心。
对 2016 年 8 月 3 日至 2018 年 6 月 21 日期间 12 个专业的 141 名主治医生进行的 22857 例手术进行了回顾性队列研究。自变量是手术医生参加术前介绍会的情况。线性回归模型比较了整体、按科室和按医生的从进入房间到切口的时间。我们假设手术医生在场时切口时间更短，并且对于具有复杂手术设备或定位的病例，效果更大。还对主治医生进行了关于术前介绍会的看法的调查，应答率为 68%（94 名主治医生中的 64 名）。
与手术医生不在场的病例相比，参加术前介绍会的病例切口时间有统计学意义但操作上较小的减少。经过协变量调整后，切口时间与效率提高 1.8±0.5 分钟（平均值±标准差；<0.001）相关。在复杂手术设备和复杂定位亚组或在比较科室的二次分析中，没有统计学上的显著差异。医生是最强的混杂变量。调查结果表明，只有轻微的支持：55%的主治医生高度重视参加术前介绍会。
手术医生是否参加术前介绍会对切口时间的效率只有微小的影响。
