Geldmaker Laura E, Hasse Christopher H, Baird Bryce A, Haehn Daniela A, Anyane-Yeboah Abena N, Wieczorek Mikolaj A, Ball Colleen T, Dora Chandler D, Lyon Timothy D, Thiel David D
Department of Urology, Mayo Clinic, Jacksonville, FL.
Department of Administration, Mayo Clinic, Jacksonville, FL.
Mayo Clin Proc Innov Qual Outcomes. 2022 Aug;6(4):373-380. doi: 10.1016/j.mayocpiqo.2022.06.002. Epub 2022 Jun 23.
To evaluate the impact of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, on operating room (OR) efficiency for urologic procedures using the concept of fixed OR times.
Over a 24-month period, urology OR data were prospectively collected. Operations were divided into fixed and variable time points. The fixed OR times were in-roomw to anesthesia-release time, anesthesia-release to cut time, in-room to cut time, and close to wheels-out time. Data from January 1, 2019, to December 31, 2019, were pre-COVID-19 data, and data from April 1, 2020, to December 31, 2020, were post-COVID-19 data. Operations were grouped into endoscopic, implant, major open, and robotic-assisted cases. In the post-COVID-19 era, all patients had a negative polymerase chain reaction test result within 48 hours of operation. The Wilcoxon rank sum test was used to compare the fixed OR times between the pre- and post-COVID-19 eras.
A total of 3189 procedures were evaluated: 2058 endoscopic operations (1124 in the pre-COVID-19 era and 934 in the post-COVID-19 era), 343 implant procedures (192 in the pre-COVID-19 era and 151 in the post-COVID-19 era), 222 major open procedures (119 in the pre-COVID-19 era and 103 in the post-COVID-19 era), and 566 robotic-assisted procedures (338 in the pre-COVID-19 era and 228 in the post-COVID-19 era). There were no fixed OR times in any of the examined groups that were negatively impacted by COVID-19. The percentage of the total OR time occupied by fixed OR variables in the pre-COVID-19 era was 40.6% for endoscopic operations, 41.1% for implant procedures, 29.8% for major open procedures, and 21.8% for robotic-assisted procedures.
A substantial portion of the total OR time includes fixed time points. Furthermore, COVID-19 did not have a negative impact on fixed OR times in a negative testing environment. Urologic OR efficiency should be maintained in the post-COVID-19 era.
运用手术室固定时间概念,评估由严重急性呼吸综合征冠状病毒2引起的2019冠状病毒病(COVID-19)对泌尿外科手术的手术室效率的影响。
在24个月期间前瞻性收集泌尿外科手术室数据。手术分为固定时间点和可变时间点。固定手术室时间包括进入手术室至麻醉苏醒时间、麻醉苏醒至切开时间、进入手术室至切开时间以及关闭切口至推出手术室时间。2019年1月1日至2019年12月31日的数据为COVID-19前数据,2020年4月1日至2020年12月31日的数据为COVID-19后数据。手术分为内镜手术、植入手术、大型开放手术和机器人辅助手术。在COVID-19后时代,所有患者在手术48小时内聚合酶链反应检测结果均为阴性。采用Wilcoxon秩和检验比较COVID-19前后时代的固定手术室时间。
共评估了3189例手术:2058例内镜手术(COVID-19前时代1124例,COVID-19后时代934例),343例植入手术(COVID-19前时代192例,COVID-19后时代151例),222例大型开放手术(COVID-19前时代119例,COVID-19后时代103例),以及566例机器人辅助手术(COVID-19前时代338例,COVID-19后时代228例)。在任何检查组中,均没有固定手术室时间受到COVID-19的负面影响。在COVID-19前时代,内镜手术中固定手术室变量占总手术室时间的百分比为40.6%,植入手术为41.1%,大型开放手术为29.8%,机器人辅助手术为21.8%。
手术室总时间的很大一部分包括固定时间点。此外,在阴性检测环境中,COVID-19对固定手术室时间没有负面影响。在COVID-19后时代应维持泌尿外科手术室效率。