Journal of perioperative practice
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We used electronic medical record (EMR) analysis to determine errors in operating room (OR) time utilisation. Over a two year period EMR data of 44,503 surgical procedures was analysed for OR duration, on-time, first case, and add-on time performance, within 19 surgical specialties. Maximal OR time utilisation at our institution could have saved over 302,620 min or 5,044 hours of OR efficiency over a two year period. ⋯ Significant differences occurred between the mean scheduled surgical durations (101.38 ± 87.11 min) and actual durations (108.18 ± 102.27 min; P < 0.001). Significant differences also occurred between the mean scheduled add-on durations (111.4 ± 75.5 min) and the actual add-on scheduled durations (118.6 ± 90.1 minutes; P < 0.001). EMR quality improvement analysis can be used to determine scheduling error and bias, in order to improve efficiency and increase OR time utilisation.
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The World Health Organisation's Safer Surgery Checklist has become an integral part of standard practice in operating theatres in the UK and other countries. However, some doubts still exist over how much of an effect the checklist actually has, with some staff feeling some resentment towards it. ⋯ The negative perceptions that surround the checklist arise from misconceptions and lack of understanding and can result in poor compliance. Further research is required across all areas but with a focus on education and implementation of strategies that address existing barriers.
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Effective teamwork in the operating theatre is important for safe patient care. In robotic surgery, the surgeon is physically separated from the operating theatre team, which could potentially have an impact on teamwork. With robotic surgery increasing internationally, this article reviews relevant published literature on teamwork in the operating theatre and reflects on how this might be impacted by robotic surgery. We conclude by describing a research study we are currently undertaking on this topic.
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As surgical and anaesthetic procedures become more complex, operating theatres need to be larger and multi-purpose to accommodate specialist equipment such as the Da Vinci Robot. The Da Vinci theatre at The Royal Wolverhampton NHS trust (RWT) is a modern theatre equipped and designed specifically for robotic surgery. When we first began to perform robotic surgery at RWT we faced many challenges on how to maximise the space available to us, whilst striving to minimise the chance of desterilisation.
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Improving efficiency within the operating theatre is always a key concern when running a successful operating list. However, with robotic surgery, this can become paramount. Robotic procedures require a more technical set up, additional planning, and good solid communication within the multidisciplinary team. ⋯ Forward planning requires knowledge of the procedures being carried out and adequate training with the robot. Trouble shooting will also improve efficiency in robotic surgery, as being able to expect the unexpected can be a major advantage. This article looks at the hurdles encountered by the theatre team at Royal Wolverhampton Trust at the implementation of the robotic programme, and how the theatre team made adjustments to working practice in order to minimise disruption and maximise efficiency.