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术者偏好的助手和员工更替对反式和解剖全肩关节置换术手术时间和并发症发生率的影响。

Effects of Surgeon-Preferred Staff and Staff Turnover on Operating Time and Complication Rates in Reverse and Anatomic Total Shoulder Arthroplasty.

机构信息

From the Department of Orthopaedic Surgery, University of Cincinnati, Clifton Ave, OH (Dr. Kurkowski, Mr. Kuechly, and Dr. Grawe), University of Cincinnati College of Medicine, Clifton Ave, OH (Mr. Gerak, Ms. Nissen, Mr. Valenti, and Mr. Patel); and the Medical College of Wisconsin School of Medicine, Milwaukee, WI (Mr. Thimmesch).

出版信息

J Am Acad Orthop Surg Glob Res Rev. 2024 May 16;8(5). doi: 10.5435/JAAOSGlobal-D-24-00104. eCollection 2024 May 1.

Abstract

BACKGROUND

This study focuses on investigating the risk factors of increased operating room time and patient complication rates after total shoulder arthroplasty cases (both reverse and anatomic). We hypothesize that the use of surgeon-preferred staff will improve operating room efficiency and reduce complication rates while increased staff turnover will decrease efficiency and increase complications.

METHODS

This is a single-center, retrospective study focused on determining the effects of staffing on operating room time and efficiency in total shoulder arthroplasty. The study included patients who underwent total shoulder arthroplasty by a single fellowship-trained orthopaedic surgeon from 2018 to 2023.

RESULTS

Four hundred twenty-three patients were included in the study from August 2018 to April 2023, 264 of which were reverse total shoulder arthroplasty (rTSA) and 159 were anatomic total shoulder arthroplasty (aTSA). In both rTSA and aTSA, the presence of surgeon-preferred staff markedly decreased operating room time. In rTSA, staff turnover increased risk of 90-day complications.

CONCLUSION

Because the presence of surgeon-preferred staff affects operating room time and efficiency, orthopaedic surgeons should train multiple surgical teams so that efficiency is not affected by the loss of personnel during a case. To reduce 90-day complication rates in rTSA, staff breaks and turnover should be minimized as much as possible because this has a direct effect on patient outcomes. Effort from hospital administration and management should be put toward reducing turnover to improve patient outcomes.

摘要

背景

本研究专注于调查全肩关节置换术(包括反肩关节置换术和解剖型肩关节置换术)患者手术时间延长和并发症发生率增加的风险因素。我们假设,使用外科医生偏好的工作人员将提高手术室效率并降低并发症发生率,而增加工作人员的更替将降低效率并增加并发症。

方法

这是一项单中心回顾性研究,旨在确定人员配备对全肩关节置换术手术室时间和效率的影响。该研究纳入了 2018 年至 2023 年期间由一名 fellowship 培训的骨科医生进行全肩关节置换术的患者。

结果

本研究共纳入 423 例患者,时间为 2018 年 8 月至 2023 年 4 月,其中 264 例为反肩关节置换术(rTSA),159 例为解剖型肩关节置换术(aTSA)。在 rTSA 和 aTSA 中,外科医生偏好的工作人员的存在显著缩短了手术时间。在 rTSA 中,工作人员更替增加了 90 天并发症的风险。

结论

由于外科医生偏好的工作人员会影响手术室时间和效率,骨科医生应培训多个手术团队,以避免人员损失对手术效率的影响。为了降低 rTSA 的 90 天并发症发生率,应尽可能减少工作人员轮休和更替,因为这会直接影响患者的治疗结果。医院行政和管理层应努力减少更替,以改善患者的治疗结果。

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