• Pieter S Stepaniak, Wietske W Vrijland, Marcel de Quelerij, Guus de Vries, and Christiaan Heij.
• Institute of Health Policy and Management, Erasmus University Rotterdam, the Netherlands. stepaniak@bmg.eur.nl
• Arch Surg. 2010 Dec 1;145(12):1165-70.

HypothesisIf variation in procedure times could be controlled or better predicted, the cost of surgeries could be reduced through improved scheduling of surgical resources. This study on the impact of similar consecutive cases on the turnover, surgical, and procedure times tests the perception that repeating the same manual tasks reduces the duration of these tasks. We hypothesize that when a fixed team works on similar consecutive cases the result will be shorter turnover and procedure duration as well as less variation as compared with the situation without a fixed team.DesignCase-control study.SettingSt Franciscus Hospital, a large general teaching hospital in Rotterdam, the Netherlands.PatientsTwo procedures, inguinal hernia repair and laparoscopic cholecystectomy, were selected and divided across a control group and a study group. Patients were randomly assigned to the study or control group.Main Outcome MeasuresPreparation time, surgical time, procedure time, and turnover time.ResultsFor inguinal hernia repair, we found a significantly lower preparation time and 10 minutes less procedure time in the study group, as compared with the control group. Variation in the study group was lower, as compared with the control group. For laparoscopic cholecystectomy, preparation time was significantly lower in the study group, as compared with the control group. For both procedures, there was a significant decrease in turnover time.ConclusionsScheduling similar consecutive cases and performing with a fixed team results in lower turnover times and preparation times. The procedure time of the inguinal hernia repair decreased significantly and has practical scheduling implications. For more complex surgery, like laparoscopic cholecystectomy, there is no effect on procedure time.

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