Implications of Perioperative Team Setups for Operating Room Management Decisions.

Doll, Dietrich; Kauf, Peter; Wieferich, Katharina; Schiffer, Ralf; Lüdi, Markus (2017). Implications of Perioperative Team Setups for Operating Room Management Decisions. Anesthesia and analgesia, 124(1), pp. 262-269. Lippincott Williams & Wilkins 10.1213/ANE.0000000000001672

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BACKGROUND Team performance has been studied extensively in the perioperative setting, but the managerial impact of interprofessional team performance remains unclear. We hypothesized that the interplay between anesthesiologists and surgeons would affect operating room turnaround times, and teams that worked together over time would become more efficient. METHODS We analyzed 13,632 surgical cases at our hospital that involved 64 surgeons and 48 anesthesiologists. We detrended and adjusted the data for potential confounders including age, American Society of Anesthesiologists physical status, and surgical list (scheduled cases of specific surgical specialties). The surgical lists were categorized as ear, nose, and throat surgery; trauma surgery; general surgery; and gynecology. We assessed the relationship between turnaround times and assignment of different anesthesiologists to specific surgeons using a Monte Carlo simulation. RESULTS We found significant differences in team performances among the different surgical lists but no team learning. We constructed managerial decision tables for the assignment of anesthesiologists to specific surgeons at our hospital. We defined a decision algorithm based on these tables. Our analysis indicated that had this algorithm been used in staffing the operating room for the surgical cases represented in our data, median turnaround times would have a reduction potential of 6.8% (95% confidence interval 6.3% to 7.1%). CONCLUSIONS A surgeon is usually predefined for scheduled surgeries (surgical list). Allocation of the right anesthesiologist to a list and to a surgeon can affect the team performance; thus, this assignment has managerial implications regarding the operating room efficiency affecting turnaround times and thus potentially overutilized time of a list at our hospital.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy

UniBE Contributor:

Lüdi, Markus

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0003-2999

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Jeannie Wurz

Date Deposited:

29 Dec 2016 12:02

Last Modified:

23 Jan 2018 12:13

Publisher DOI:

10.1213/ANE.0000000000001672

PubMed ID:

27918327

BORIS DOI:

10.7892/boris.91173

URI:

https://boris.unibe.ch/id/eprint/91173

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