Efficiency improvement in the operating room

详细信息    查看全文

• 作者：Abigail J. Fong ; MBA^a ; ^b ; Meghan Smith ; MBA^a ; ^c ; Alexander Langerman ; MD ; SM^a ; ^c ; ^{alexander.langerman@vanderbilt.edu" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Efficiency ; Operating room ; Surgery ; Intraoperative ; Lean ; Six sigma ; Total quality improvement ; Process mapping
• 刊名：Journal of Surgical Research
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：204
• 期：2
• 页码：371-383
• 全文大小：1676 K

文摘

In the changing health care environment, health systems, hospitals, and health care providers must focus on improving efficiency to meet an increasing demand for high-quality, low-cost health care. Much has been written about strategies and efforts to improve efficiency in the perioperative periods, yet the time when the patient is in the operating room—the intraoperative period—has received less attention. Yet, this is the period in which surgeons may have the most influence.

Methods

Systematically review published efforts to improve intraoperative efficiency; assess the outcomes of these efforts, and propose standardized reporting of future studies.

Results

A total of 39 studies were identified that met inclusion criteria. These divided naturally into small (single operative team), medium (multi-operative team), and large (institutional) interventions. Most studies used time or money as their metric for efficiency, though others were used as well.

Conclusions

There is substantial opportunity to enhance operating room efficiency during the intraoperative period. Surgeons may have a particular role in procedural efficiency, which has been relatively unstudied. Common themes were standardizing tasks, collecting and using actionable data, and maintaining effective team communication.