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Anesthesia and analgesia · Jan 2017
Implications of Perioperative Team Setups for Operating Room Management Decisions.
- Dietrich Doll, Peter Kauf, Katharina Wieferich, Ralf Schiffer, and Markus M Luedi.
- From the *Department of Surgery, St. Marienhospital Vechta, Academic Teaching Hospital of the Medical School Hannover, Vechta, Germany; †PrognosiX AG, Zurich, Switzerland, and the Institute of Applied Simulation, Zurich University of Applied Sciences ZHAW, Waedenswil, Switzerland; ‡Saint Mary's Hospital Vechta, Teaching Hospital of Hannover University, Vechta, Germany; and §Department of Anesthesiology, Bern University Hospital Inselspital, University of Bern, Bern, Switzerland.
- Anesth. Analg. 2017 Jan 1; 124 (1): 262-269.
BackgroundTeam 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.MethodsWe 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.ResultsWe 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%).ConclusionsA 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.
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