Sunil Eappen1, Hugh Flanagan, Rachel Lithman, Neil Bhattacharyya. 1. Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA 02115, USA. seappen@partners.org
Abstract
STUDY OBJECTIVE: To determine whether a regional block team with a dedicated space for performance of regional anesthetics would decrease turnover time and shorten the working day in a busy orthopedic practice with lengthy turnover times. DESIGN: Prospective, randomized study. SETTING: Tertiary-care teaching hospital. PATIENTS: 927 orthopedic procedures over a three-month period. INTERVENTIONS: The randomized placement of a regional block team to the orthopedic operating room (OR) suite. MEASUREMENTS: We evaluated the differences in anesthesia-controlled times, first-case start times, turnover times, and OR end times using a computerized OR information system. We also surveyed the surgeons regarding their perceptions of changes in turnover time and anesthesia-controlled times during the study period. Standard descriptive statistics were computed. RESULTS:Of a total of 927 cases, 398 cases were cared for by a regional block team and 529 cases received care in the usual manner, with the OR team providing the regional block. There was no difference between the study and control groups for on-time, first-case starts (57.73% vs 42.27%), induction time (13.2 vs 14.2 min), emergence time (8.1 vs 9.0 min), turnover time (70.3 vs 77.8 min), and OR end times. Most of the surgeons surveyed felt that the regional block team reduced turnover time significantly. CONCLUSION: A regional block team in this environment does not reduce anesthesia-controlled times and turnover times in an orthopedic OR suite with long turnover times, and it would be virtually impossible to recover the associated extra cost. The surgeons' perspective of turnover time is inaccurate.
RCT Entities:
STUDY OBJECTIVE: To determine whether a regional block team with a dedicated space for performance of regional anesthetics would decrease turnover time and shorten the working day in a busy orthopedic practice with lengthy turnover times. DESIGN: Prospective, randomized study. SETTING: Tertiary-care teaching hospital. PATIENTS: 927 orthopedic procedures over a three-month period. INTERVENTIONS: The randomized placement of a regional block team to the orthopedic operating room (OR) suite. MEASUREMENTS: We evaluated the differences in anesthesia-controlled times, first-case start times, turnover times, and OR end times using a computerized OR information system. We also surveyed the surgeons regarding their perceptions of changes in turnover time and anesthesia-controlled times during the study period. Standard descriptive statistics were computed. RESULTS: Of a total of 927 cases, 398 cases were cared for by a regional block team and 529 cases received care in the usual manner, with the OR team providing the regional block. There was no difference between the study and control groups for on-time, first-case starts (57.73% vs 42.27%), induction time (13.2 vs 14.2 min), emergence time (8.1 vs 9.0 min), turnover time (70.3 vs 77.8 min), and OR end times. Most of the surgeons surveyed felt that the regional block team reduced turnover time significantly. CONCLUSION: A regional block team in this environment does not reduce anesthesia-controlled times and turnover times in an orthopedic OR suite with long turnover times, and it would be virtually impossible to recover the associated extra cost. The surgeons' perspective of turnover time is inaccurate.