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At least 181 records · Page 10Linked to original sources
PubMed1996

Statistical modeling to predict elective surgery time. Comparison with a computer scheduling system and surgeon-provided estimates.

BACKGROUND: Accurate estimation of operating times is a prerequisite for the efficient scheduling of the operating suite. The authors, in this study, sought to compare surgeons' time estimates for elective cases with those of commercial scheduling software, and to ascertain whether improvements could be made by regression modeling. METHODS: The study was conducted at the University of Washington Medical Center in three phases. Phase 1 retrospectively reviewed surgeons' time estimates and the scheduling system's estimates throughout 1 yr. In phase 2, data were collected prospectively from participating surgeons by means of a data entry form completed at the time of scheduling elective cases. Data included the procedure code, estimated operating time, estimated case difficulty, and potential factors that might affect the duration. In phase 3, identical data were collected from five selected surgeons by personal interview. RESULTS: In phase 1, 26 of 43 surgeons provided significantly better estimates than did the scheduling system (P < 0.01), and no surgeon was significantly worse, although the absolute errors were large (34% of 157 min average case length). In phase 2, modeling improved the accuracy of the surgeons' estimates by 11.5%, compared with the scheduling system. In phase 3, applying the model from phase 2 improved the accuracy of the surgeons' estimates by 18.2%. CONCLUSIONS: Surgeons provide more accurate time estimates than does the scheduling software as it is used in our institution. Regression modeling effects modest improvements in accuracy. Further improvements would be likely if the hospital information system could provide timely historical data and feedback to the surgeons.

Appointments and Schedules↗
PubMed1995

[Requirements for a surgical documentation system and its realization].

Adequate documentation of all surgical procedures is now essential. High demands in terms of quality and quantity mean that computerized databases and evaluation procedures are required. In the Department of Abdominal and Transplantation Surgery within Hanover Medical School a standardized but individually adaptable documentation system has been greated using standard hardware and software. A hierarchical code system has been established for surgical procedures, and this also offers the options of automatic online coding and translation into the coding used in the International Classification of Procedures in Medicine. The advantages and limitations of this system are discussed.

Database Management Systems↗
PubMed2005

Integration of hospital information systems, operative and peri-operative information systems, and operative equipment into a single information display.

The integration of disparate information systems in the operative environment allows access to information that is typically unseen or unused. Through a collaborative effort, a variety of information systems and surgical equipment are being integrated. This provides improved context-sensitive information display and decision support and improved access to information to improve workflow, safety and visualization of information that was previously unattainable.

Data Display↗
PubMed2004

Introduction of anesthesia resident trainees to the operating room does not lead to changes in anesthesia-controlled times for efficiency measures.

BACKGROUND: Operating room efficiency is an important concern in most hospitals today. Little work has been reported to evaluate the contribution of anesthesia residents to changes in anesthesia-controlled time-related efficiencies in the operating room. The goal of this study was to measure the impact of the initiation of new residents to the operating room on anesthesia-related time measures of operating room efficiency. METHODS: Using the computerized operating room information systems, specific data regarding anesthesia-controlled times were extracted over three distinct 2-week periods over the course of 1 academic year. These included the first 2 weeks of July, when most of the operating rooms were staffed by attending physicians working alone; 2 weeks in September when new anesthesia residents were working in a 2:1 ratio with staff; and 2 weeks in May. The induction times, emergence times, and room turnover times were compared over these three periods for first-year anesthesia residents. Standard descriptive statistics were computed. Analysis of variance testing was then conducted comparing each of these time periods. Significance was set at P < 0.05. RESULTS: A total of 3,004 surgical procedures were performed during the 2-week study periods in July, September, and May, respectively. For the July, September, and May groups, the mean anesthesia induction times were 17.3, 19.0, and 20.8 min (P = 0.047); the emergence times were 8.7, 9.7, and 10.0 min, (P = 0.024); and the corresponding mean room turnover times were 47.6, 48.5, and 48.6 min (P = 0.907), respectively. CONCLUSION: Although statistically significant time differences were found, these data strongly suggest that the initiation of anesthesia trainees to the operating room has no clinically or economically meaningful adverse effect on the anesthesia-controlled time component of operating room efficiency.

Anesthesia↗
PubMed1986

The case for using computers in the operating room.

The largest cost center and revenue generator in most hospitals, the operating room is subject to demands for increased cost accountability and quality assurance. Information technology tools can be incorporated into the operating room and have the potential to positively affect practices there through addressing nursing, administrative/financial and medical needs. Microcomputer-based operating room systems now on the market can provide functions from scheduling and case costing to medical records and market analysis. Of 21 functions identified, 10 can be characterized as mandatory and the remaining as optional. Individual systems offer varied configurations, providing from 0 to 21 functions. These enhanced capabilities for data collection, monitoring and analysis enable health care professionals to provide both better and more cost-effective care for surgical patients.

Computers↗
PubMed1999

Estimating the duration of a case when the surgeon has not recently scheduled the procedure at the surgical suite.

UNLABELLED: For some scheduled cases, there may be no previous cases of the same procedure type by the same surgeon for use in estimating the duration of the new case. We evaluated which of 16 different methods of analysis of other surgeons' cases of the same procedure type resulted in the most accurate prediction of the duration of the case that the surgeon had not recently scheduled. We analyzed durations for 4,955 cases, from an operating room information system, for which a surgeon had only scheduled the procedure once, and for which other surgeons had scheduled that same procedure one or more times. Using these data, we determined the difference between the actual duration of the new case and the estimated duration of the new case as calculated by each of the methods (average absolute error of 1.1 h with average case duration of 3.1 h). IMPLICATIONS: When no recent historical time data are available for a surgeon doing a given procedure, the mean of the durations of cases of the same scheduled procedure performed by other surgeons is as accurate an estimate as more sophisticated analyses. More research is needed to improve the precision of estimates of case durations.

Appointments and Schedules↗
PubMed2001

A statistical analysis of weekday operating room anesthesia group staffing costs at nine independently managed surgical suites.

UNLABELLED: At many surgical suites, surgeons and patients schedule elective cases on whatever future workday they choose, resulting in there being no limit on the number of cases performed each day. Staff are then scheduled in the manner that satisfies the marketing guarantee to the surgeons, satisfies labor contracts, and minimizes staffing costs. We assessed weekday nurse anesthesia group staffing at nine such suites to determine whether statistical methods can identify staffing solutions whereby all the cases are covered but for which staffing costs are less than those obtained using the staffing plans implemented by anesthesia groups' managers. Two years of operating room information system case duration and staffing data were analyzed. First- and second-shift staffing was assessed using previously published algorithms. The statistical methods identified staffing solutions with significantly decreased labor costs than those currently being used at eight of the nine surgical suites. The statistical methods relied more on overtime than second-shift staffing. The incremental decrease in staffing costs achievable by using overlapping 8-, 10-, and 13-h shifts was negligible. Overall, we found that statistical methods can identify, for some surgical suites, staffing solutions whereby all the cases are covered but for which costs are significantly less and productivity significantly more than those obtained using the plans developed by the managers based on their experience and the data. IMPLICATIONS: Statistical methods can identify, for some surgical suites, anesthesia staffing solutions whereby all the cases are covered but for which labor costs are significantly less than those obtained using the staffing plans developed by the managers based on data and their experience.

Anesthesia↗