Georgetown University School of Medicine, Washington, DC, USA.
Department of Neurosurgery, MedStar Georgetown University Hospital, 3800 Reservoir Road NW, Washington, DC, PHC7, USA.
World J Surg. 2022 Dec;46(12):2939-2945. doi: 10.1007/s00268-022-06724-5. Epub 2022 Sep 6.
Efficient resource management in the operating room (OR) contributes significantly to healthcare expenditure and revenue generation for health systems. We aim to assess the influence that surgeon, anesthesiology, and nursing team assignments and time of day have on turnover time (TOT) in the OR.
We performed a retrospective review of elective cases at a single academic hospital that were completed between Monday and Friday between the hours of 0700 and 2359 from July 1, 2017, through March 31, 2018. Emergent cases and unplanned, add-on cases were excluded. Data regarding patient characteristics, OR teams, TOT, and procedure start and end times were collected and analyzed.
A total of 2174 total cases across 13 different specialties were included in our study. A multivariate regression of relevant variables affecting TOT was performed. Consecutive specialty (p < 0.0001), consecutive surgeon (p < 0.0001), anesthesiologist (p < 0.0001), and prior case ending before 1400 (p < 0.0001) were independent predictors of lower TOT. A receiver operating characteristic analysis demonstrated an area under the curve of 0.848 and a cutoff of 1400 having the highest sensitivity and specificity for TOT difference.
TOT can be significantly affected by the time of the day the procedure is performed. Staffing availability during late procedures and the differences in how OR team staff are scheduled may affect OR efficiency. Additional studies may be needed to determine the long-term implications of changes implemented to decrease organizational operational costs related to the OR.
手术室（OR）的资源管理效率对医疗系统的医疗支出和收入产生重大影响。我们旨在评估外科医生、麻醉师和护理团队的分配以及一天中的时间对手术室周转时间（TOT）的影响。
我们对 2017 年 7 月 1 日至 2018 年 3 月 31 日期间周一至周五每天 07:00 至 23:59 在一家学术医院完成的择期手术进行了回顾性研究。排除紧急情况和非计划、附加病例。收集并分析了有关患者特征、OR 团队、TOT 以及手术开始和结束时间的数据。
共有 2174 例来自 13 个不同专业的总病例纳入我们的研究。对影响 TOT 的相关变量进行了多变量回归。连续专业（p < 0.0001）、连续外科医生（p < 0.0001）、麻醉师（p < 0.0001）和 1400 点之前结束的先前病例（p < 0.0001）是 TOT 较低的独立预测因素。受试者工作特征分析显示曲线下面积为 0.848，截止值为 1400 时 TOT 差异的灵敏度和特异性最高。
手术时间可显著影响 TOT。晚期手术期间的人员可用性以及 OR 团队人员的安排差异可能会影响 OR 效率。可能需要进一步研究以确定为降低与 OR 相关的组织运营成本而实施的变更的长期影响。
