南非一家三级眼科医院手术室的效率。

Operating theatre efficiency at a tertiary eye hospital in South Africa.

机构信息

Department of Ophthalmology, Charlotte Maxeke Johannesburg Academic Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

出版信息

S Afr Med J. 2023 May 5;113(5):59-64. doi: 10.7196/SAMJ.2023.v113i5.16602.

DOI:10.7196/SAMJ.2023.v113i5.16602

PMID:37170602

Abstract

BACKGROUND

South Africa (SA) is a resource-limited country that needs efficient operating theatres in order for surgical care to function cost-effectively. Regular assessment of theatre efficiency in our setting is therefore needed.

OBJECTIVES

To describe ophthalmology theatre efficiency at a central hospital in SA and compare this with international benchmarks.

METHODS

St John Eye Hospital is the ophthalmology section of Chris Hani Baragwanath Academic Hospital in Soweto, SA. It has three operating theatres. A cross-sectional study was done of the theatres' registry of surgical procedures over a 6-month period. Data analysed included the starting and finishing times of theatre lists, surgical cases that were cancelled on the day of surgery, and theatre utilisation rates. These data were compared with international benchmarks.

RESULTS

A total of 1 482 surgical procedures in 229 theatre lists were included in the study. Sixty-five percent of these theatre lists started late, accounting for 4 236 minutes of lost theatre time, significantly more than the maximum of 10% recommended by the Royal College of Anaesthetists. Of theatre lists, 23% and 30% finished after 16h15 (theatre overrun) and before 16h00 (theatre underrun), respectively. This is more than double the 10% recommended by the Royal College of Anaesthetists. The theatre utilisation rate was 62%, which is significantly lower than the ideal utilisation rate of 80%. The cancellation rate was 16%, which is significantly higher than the international benchmark of 2% recommended by the New South Wales guidelines. The most common reasons for cancellations were medical unfitness of the patient and lack of operating theatre time.

CONCLUSION

All theatre efficiency parameters at St John Eye Hospital were below international benchmarks.

摘要

背景

南非（SA）是一个资源有限的国家，需要高效的手术室，以便外科护理能够具有成本效益。因此，有必要定期评估我们手术室的效率。

目的

描述南非一家中央医院的眼科手术室效率，并将其与国际基准进行比较。

方法

约翰尼斯堡眼医院是索韦托克里斯·哈尼·巴哈纳特大学校医院的眼科部分。它有三个手术室。在 6 个月的时间里，对手术室手术程序的登记册进行了横断面研究。分析的数据包括手术室名单的开始和结束时间、当天取消的手术病例以及手术室利用率。将这些数据与国际基准进行了比较。

结果

共有 229 个手术室名单中的 1482 例手术被纳入研究。其中 65%的手术室名单延迟开始，手术室损失时间达 4236 分钟，明显超过皇家麻醉师学院建议的 10%的最大损失时间。23%和 30%的手术室名单分别在 16 点 15 分（手术室超时）和 16 点（手术室未充分利用）之后结束，这比皇家麻醉师学院建议的 10%要多一倍。手术室利用率为 62%，明显低于理想利用率 80%。取消率为 16%，明显高于新南威尔士州指南建议的国际基准 2%。取消的最常见原因是患者身体状况不佳和缺乏手术室时间。