Developing a high-efficiency operating room for total joint arthroplasty in an academic setting.
Background: Developing a high-efficiency operating room (OR) for total joint arthroplasty (TJA) in an academic setting is challenging given the preexisting work cultures, bureaucratic road blocks, and departmental silo mentalities. Also, academic institutions and aligned surgeons must have strategie...
| Publicado en: | Clinical Orthopaedics & Related Research® Vol. 471; no. 6; pp. 1832 - 1837 |
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| Autores principales: | , , , |
| Formato: | Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
Jun2013
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104280209&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104280209 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0009921X 23N jtl: Clinical Orthopaedics & Related Research® issn: 0009921X maglogo: N pubinfo: dt: Jun2013 vid: 471 iid: 6 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 104280209 NLM23208123 2012103048 10.1007/s11999-012-2718-4 NLM23208123 104280209 ppf: 1832 ppct: 5 formats: tig: atl: Developing a high-efficiency operating room for total joint arthroplasty in an academic setting. aug: au: Attarian, David E Wahl, Jennie E Wellman, Samuel S Bolognesi, Michael P affil: Department of Orthopaedic Surgery, Duke University Hospital and Health System, Duke Medicine Plaza-Page Road, 4709 Creekstone Road, Suite 200, Durham, NC, 27703, USA, david.attarian@duke.edu. sug: subj: Academic Medical Centers Arthroplasty, Replacement Health Care Delivery, Integrated Administration Hospital Design and Construction Methods Operating Rooms Administration Cooperative Behavior Organizational Efficiency Systems Analysis ab: Background: Developing a high-efficiency operating room (OR) for total joint arthroplasty (TJA) in an academic setting is challenging given the preexisting work cultures, bureaucratic road blocks, and departmental silo mentalities. Also, academic institutions and aligned surgeons must have strategies to become more efficient and productive in the rapidly changing healthcare marketplace to ensure future financial viability.Questions/purposes: We identified specific resources and personnel dedicated to our OR for TJA, assessed the typical associated work process delays, and implemented changes and set goals to improve OR efficiencies, including more on-time starts and shorter turnover times, to perform more TJA cases per OR. We then compared these variables before and after project initiation to determine whether our goals were achieved.Methods: We gathered 1 year of retrospective TJA OR time data (starting, completion, turnover times) and combined these data with 1 month of prospective observations of the workflow (patient check-in, patient processing and preparation, OR setup, anesthesia, surgeon behaviors, patient pathway). The summarized information, including delays and inefficiencies, was presented to a multidisciplinary committee of stakeholders; recommendations were formulated, implemented, and revised quarterly. Key strategies included dedicated OR efficiency teams, parallel processing, dedicated hospital resources, and modified physician behavior. OR data were gathered and compared 3 years later.Results: After project changes, on-time OR starts increased from less than 60% to greater than 90% and average turnover time decreased from greater than 60 minutes to 35 minutes. Our average number of TJA cases per OR increased by 29% during the course of this project.Conclusions: Our project achieved improved OR efficiency and productivity using strategies such as process and resource analysis, improved communication, elimination of silo mentalities, and team work. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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