Marco A Mascarella1, Nadia Lahrichi2, Fabienne Cloutier3, Simcha Kleiman4, Richard J Payne1, Lawrence Rosenberg5. 1. Department of Otolaryngology-Head & Neck Surgery, McGill University, Montreal, Canada. 2. Department of Mathematical and Industrial Engineering, Polytehcnique Montreal, Montreal, Canada. 3. Department of Nursing, Jewish General Hospital, Montreal, Canada. 4. Department of Anesthesia, McGill University, Montreal, Canada. 5. Department of Surgery, Jewish General Hospital, McGill University, Montreal, Canada. Electronic address: lawrence.rosenberg@mcgill.ca.
Abstract
BACKGROUND: We developed a high efficiency endocrine operative protocol based on a mathematical programming approach, process reengineering, and value-stream mapping to increase the number of operations completed per day without increasing operating room time at a tertiary-care, academic center. METHODS: Using this protocol, a case-control study of 72 patients undergoing endocrine operation during high efficiency days were age, sex, and procedure-matched to 72 patients undergoing operation during standard days. The demographic profile, operative times, and perioperative complications were noted. RESULTS: The average number of cases per 8-hour workday in the high efficiency and standard operating rooms were 7 and 5, respectively. Mean procedure times in both groups were similar. The turnaround time (mean ± standard deviation) in the high efficiency group was 8.5 (±2.7) minutes as compared with 15.4 (±4.9) minutes in the standard group (P < .001). Transient postoperative hypocalcemia was 6.9% (5/72) and 8.3% (6/72) for the high efficiency and standard groups, respectively (P = .99). CONCLUSION: In this study, patients undergoing high efficiency endocrine operation had similar procedure times and perioperative complications compared with the standard group. The proposed high efficiency protocol seems to better utilize operative time and decrease the backlog of patients waiting for endocrine operation in a country with a universal national health care program.
BACKGROUND: We developed a high efficiency endocrine operative protocol based on a mathematical programming approach, process reengineering, and value-stream mapping to increase the number of operations completed per day without increasing operating room time at a tertiary-care, academic center. METHODS: Using this protocol, a case-control study of 72 patients undergoing endocrine operation during high efficiency days were age, sex, and procedure-matched to 72 patients undergoing operation during standard days. The demographic profile, operative times, and perioperative complications were noted. RESULTS: The average number of cases per 8-hour workday in the high efficiency and standard operating rooms were 7 and 5, respectively. Mean procedure times in both groups were similar. The turnaround time (mean ± standard deviation) in the high efficiency group was 8.5 (±2.7) minutes as compared with 15.4 (±4.9) minutes in the standard group (P < .001). Transient postoperative hypocalcemia was 6.9% (5/72) and 8.3% (6/72) for the high efficiency and standard groups, respectively (P = .99). CONCLUSION: In this study, patients undergoing high efficiency endocrine operation had similar procedure times and perioperative complications compared with the standard group. The proposed high efficiency protocol seems to better utilize operative time and decrease the backlog of patients waiting for endocrine operation in a country with a universal national health care program.
Authors: Juan A Marin-Garcia; Pilar I Vidal-Carreras; Julio J Garcia-Sabater Journal: Int J Environ Res Public Health Date: 2021-01-22 Impact factor: 3.390
Authors: Hannah Ernst; Leigh Sowerby; Axel Sahovaler; Danielle Macneil; Anthony Nichols; John Yoo; Richard Hilsden; Julie Strychowsky; Kevin Fung Journal: J Otolaryngol Head Neck Surg Date: 2021-07-08