Implementing Instructional Supervision by an Operating Room Assistant to Reduce Turnover Time
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2018, Vol 4, Issue 2
Abstract
Background: Turnover time is still not negligible in ensuring efficient operating room(OR) management. A prospective study was performed to evaluate the effect of instructional supervision by an OR assistant on reducing turnover time. Material and Methods: We prospectively included surgical cases undergoing turnover operation after the first case from two ORs in a single center between Mar 2015 and Feb 2016. Cases in one OR received the instructional supervision by an OR assistant. Cases in another OR received not. The primary endpoint was the percentage of surgical case with turnover time ≤ 45min. Other endpoints were turnover time, the percentage of the teamwork score of OR staffs ≥4 point and the percentage of patient satisfaction score≥4 point. Results: Over 48 weeks, the effect of instructional supervision was evaluated in 1826 surgical cases undergoing turnover operation. Compared with those in the non-intervention group(n=904), the percentage of surgical cases with turnover time ≤ 45min decreased significantly (80.4% VS 59.6%, P<0.001) in the instructional supervision group(n=922). In the instructional supervision group, there was a significant improvement in turnover time (49.6min VS 37.9min; P<0.001), the percentage of the teamwork score≥4 point (84.8% VS 79.4%; P=0.003) and the percentage of patient satisfaction score≥4 point (89.7% VS 78.1%, P<0.001). Conclusion: Implementing instructional supervision by an OR assistant can potentially reduce our OR turnover time. Hospitals must focus on improving operating room(OR) efficiency to achieve an appropriate target of high-quality, lowcost care. Eight efficiency indicators including time management were identified as most critical for monitoring OR performance [1]. Improving intraoperative efficiency-time savings may translate to an earlier finish or the opportunity to perform more cases during the same block time [2]. A surgeon’s operative time can be difficult to regulate as each procedure can have different degrees of difficulty due to patient-specific factors. However, many of the processes in the OR are common, particularly those not associated with the procedure itself, and these might be optimized to assure more efficient and better care such as turnover time [3]. In China, there are a huge amount of operations in every large size tertiary comprehensive hospital, it is urgent to reduce turnover time for minimum economic costs.In previous two before-after controlled studies [4,5] lean Six Sigma methodology and another changed lean methodology were applied to decrease OR turnover time. But these broadly applicable interventions based on strategies used in other time pressured industries and translated into health care, can provide the basis for considerable and sustainable improvements in turnover time. Weld LR et al. [6] found Team STEPPS (team strategies and tools to enhance performance and patient safety) had no effects on OR turnover time. There have been no prospective parallel-controlled studies to specifically evaluate the effect of instructional supervision on OR turnover time.Long, inefficient and unpredictable OR turnover time can reduce surgical productivity, affecting the ability to treat patients, with potentially serious financial implications [7]. The aim of this study is to assess whether an intervention implementing instructional supervision by an OR assistant would impact OR turnover time.
Authors and Affiliations
Xiaohua Pan, Hui Zhou, Weihua Li, Jie Zhang, Yibing Si, Gendi Li
Keywords
Related Articles
- EP ID EP590889
- DOI 10.26717/BJSTR.2018.04.001031
- Views 132
- Downloads 0
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