Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
St Joseph's Health Care London, London, Ontario, Canada.
Otolaryngol Head Neck Surg. 2020 Feb;162(2):215-219. doi: 10.1177/0194599819885635. Epub 2019 Oct 22.
As health care expenditures rise, novel ways to increase efficiency are sought. The operating room (OR) represents an area where there is opportunity to optimize work flow and supply use. Evidence suggests that instrument redundancy in the OR tends to be high and that direct cost savings can be achieved by "optimizing" surgical trays. The purpose of this study was to quantify the potential time savings associated with surgical tray optimization.
Instrument utilization was reviewed for 4 procedures: tonsillectomy, sinus surgery, septoplasty, and septorhinoplasty. Instruments used in <20% of cases were excluded. Data on tray assembly time in the central processing department and instrument setup time in the OR were prospectively collected over a 3-month period before and after tray optimization. Student's test (α = 0.05) was used to determine whether times were significantly different following optimization.
Tray assembly times were found to be significantly shorter following optimization, with percentage reduction in time ranging from 58% to 66% ( < .05). In the OR, percentage reduction in setup time ranged from 26% to 37% ( < .05). Variability in assembly and setup times was also found to be narrower postoptimization.
Tray optimization may reduce stress and adverse events and allow managers to better estimate staffing requirements. Cost-benefits could not be determined given a limited understanding of how departments choose to redistribute time savings.
Measurable and significant time savings can be achieved by assessing instrument utilization rates and reducing tray redundancy, leading to lower performance variability and improved efficiency.
随着医疗保健支出的增加,人们正在寻找提高效率的新方法。手术室(OR)是一个有机会优化工作流程和供应使用的领域。有证据表明,手术室中的器械冗余往往很高,通过“优化”手术托盘可以直接节省成本。本研究的目的是量化与手术托盘优化相关的潜在时间节省。
对扁桃体切除术、鼻窦手术、鼻中隔成形术和鼻中隔成形术 4 种手术的器械使用情况进行了回顾。排除了在<20%的情况下使用的器械。在托盘优化前后的 3 个月期间,前瞻性地收集了中央处理部门的托盘组装时间和 OR 中的器械设置时间的数据。使用学生 t 检验(α=0.05)来确定优化后时间是否存在显著差异。
发现托盘组装时间在优化后明显缩短,时间减少的百分比范围为 58%至 66%(<0.05)。在 OR 中,设置时间的百分比减少范围为 26%至 37%(<0.05)。优化后,组装和设置时间的变异性也发现更窄。
托盘优化可以减轻压力和不良事件,并使管理人员能够更好地估计人员配备需求。鉴于对部门如何选择重新分配节省的时间的理解有限,无法确定成本效益。
通过评估器械使用率和减少托盘冗余,可以实现可衡量且显著的时间节省,从而降低绩效变异性并提高效率。