Perioperative Care and Operating Room Management最新文献

{"title":"Open reduction internal fixation in patella fracture using wide awake local anesthesia no tourniquet technique (WALANT) – A case series","authors":"Chinnakart Boonyasirikool,&nbsp;Chananyu Susrivaraput,&nbsp;Sunyarn Niempoog","doi":"10.1016/j.pcorm.2024.100417","DOIUrl":"10.1016/j.pcorm.2024.100417","url":null,"abstract":"<div><h3>Background</h3><p>Wide Awake Local Anesthesia No Tourniquet (WALANT) has been accepted safe and effective anesthesia technique for many orthopaedics procedures. Despite growing number of studies, few had described using WALANT in lower extremities with more complexity like the knee. We present a case series of patella fracture fixation using WALANT.</p></div><div><h3>Methods</h3><p>WALANT was used as a method of anesthesia for five patients diagnosed with patella fracture undergone tension band wiring fixation at Thammasat University hospital during 2021 - 2022. Visual analog scale (VAS) was collected throughout the surgery as primary objective and up to 48 h after the operation. We also evaluated their demographic and clinical data, range of motion, total operative time, amount of WALANT used, blood loss and hospital stay.</p></div><div><h3>Results</h3><p>Throughout the procedure, all patients reported no pain or discomfort except at wiring step which average VAS was 2.4 ± 1.14. The mean total operative time was 91.6 ± 18.58 min and mean WALANT solution used was 124 ± 12.94 ml. The visualization of surgical field was satisfying with minimal blood loss. All patients were able to walk with weight-bearing as tolerated right after the operation and were discharged in the same day except one due to lack of caregivers at home. Neither local nor systemic complications were found. No conversion to other anesthesia techniques due to failure of WALANT.</p></div><div><h3>Conclusions</h3><p>This study shows WALANT may be considered safe and effective as an alternative anesthesia technique for patella fracture fixation in ambulatory setting, offering favorable outcome without need for postoperative hospitalization.</p></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"37 ","pages":"Article 100417"},"PeriodicalIF":0.0,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142083631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between clinical decision-making levels and self-efficacy levels of operating room nurses","authors":"Sedat Kaya ,&nbsp;Gizem Kubat Bakir","doi":"10.1016/j.pcorm.2024.100416","DOIUrl":"10.1016/j.pcorm.2024.100416","url":null,"abstract":"<div><h3>Background</h3><p>Clinical decision-making and self-efficacy levels of operating room nurses are critical for patient care quality and safety.</p></div><div><h3>Objective</h3><p>This study aims to examine the relationship between clinical decision-making levels and self-efficacy among operating room nurses and to identify factors influencing these two key components of nursing practice.</p></div><div><h3>Methods</h3><p>A cross-sectional descriptive design was used to survey 94 nurses working in surgical wards at Ankara University Medical Faculty Hospital. Data were collected using the Clinical Decision Making in Nursing Scale (CDMNS), General Self-Efficacy Scale (GSES), and a demographic information form. Data were analyzed using descriptive statistics, correlation analysis, and group comparisons.</p></div><div><h3>Results</h3><p>A significant positive correlation was found between clinical decision-making ability and self-efficacy (<em>r</em> = 0.355, <em>p</em> &lt; .0001). Nurses with higher education levels demonstrated significantly greater clinical decision-making skills (<em>p</em> &lt; .005). Nurse managers reported significantly higher self-efficacy levels compared to scrub/circulating nurses (<em>p</em> &lt; .05). Age was positively correlated with self-efficacy (<em>r</em> = 0.373, <em>p</em> &lt; .0001) but not with clinical decision-making ability.</p></div><div><h3>Conclusion</h3><p>The research indicated that self-efficacy levels correspond with clinical decision-making capabilities of the operating room nurses. Higher education levels of the practitioners enhanced their clinical decision-making abilities. Nurse managers had higher self-efficacious beliefs than the scrub or circulating nurses. Age was positively associated with self-efficacy, but not with the scores on clinical decision-making abilities. The results of this study nurse leaders have higher GSES and CDMNS scores because they are experienced nurses with higher education degrees.</p></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"37 ","pages":"Article 100416"},"PeriodicalIF":0.0,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142089030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and safety of ultrasound-guided supra-clavicular block in children","authors":"Ahmed Ben Slimene,&nbsp;Mehdi Trifa,&nbsp;Hajer Blaiti,&nbsp;Salma Aouadi,&nbsp;Adel Beji,&nbsp;Mohamed Amine Ben Hafsa,&nbsp;Joshua D Cox","doi":"10.1016/j.pcorm.2024.100422","DOIUrl":"10.1016/j.pcorm.2024.100422","url":null,"abstract":"<div><h3>Background</h3><p>Ultrasound-guided supra-clavicular nerve block (SCNB) has regained interest in adults but remains underutilized in pediatrics. This case series aims to evaluate the efficacy and safety of ultrasound-guided SCNB in children undergoing upper-extremity surgery.</p></div><div><h3>Methods</h3><p>Prospective observational case series, the inclusion criteria were children over one year old who were scheduled for elective upper-extremity surgery. After induction of general anesthesia, an ultrasound-guided SCNB was performed. A dose of 0.2–0.5 ml/kg of bupivacaine 0.25 % or ropivacaine 0.2 % was administered all around the brachial plexus. In case of postoperative pain, 15 mg kg^-1 of paracetamol + 10 mg kg^-1 of ibuprofen were administered. The primary outcome measure was the success and safety of the block. Secondary outcomes were time to first analgesia administration and duration of motor blockade.</p></div><div><h3>Results</h3><p>Thirty-three patients were included. Median age and weight were 6 [2.75,9.75] years and 24 [16,35] kg, respectively with a sex ratio of 3.1. Bupivacaine 0.25 % was used in the majority of cases (<em>N</em> = 24). The overall duration to complete block performance was 170 [120,300] seconds. A single attempt was sufficient for the majority of children, with a block success rate of 100 %. No incidents were reported during block performance. Postoperatively, time to the first analgesic request was 10 [8,12.5] hours. Twenty-five patients developed a motor block, with a duration of 4 [0.5,5] hours. Bupivacaine 0.25 % was associated with higher incidence of motor blockade (<em>p</em> = 0.002).</p></div><div><h3>Conclusions</h3><p>Ultrasound-guided SCNB appears to be an effective and safe technique in children. Further studies using lower doses of bupivacaine could help reduce the incidence of motor block.</p></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"37 ","pages":"Article 100422"},"PeriodicalIF":0.0,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142058326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of stress ball use on subcutaneous injection procedural pain in orthopedic patients: Randomized controlled trial","authors":"Figen Diğin ,&nbsp;Zeynep Kizilcik Özkan","doi":"10.1016/j.pcorm.2024.100421","DOIUrl":"10.1016/j.pcorm.2024.100421","url":null,"abstract":"<div><h3>Background</h3><p>Patients may feel pain during subcutaneous injection and drug absorption that ranges in intensity. The purpose of this study is to determine the effect of stress ball use on procedural pain due to subcutaneous injection in orthopedic patients.</p></div><div><h3>Method</h3><p>The randomized controlled study was conducted with the participation of 134 patients (67 experimental group - 67 control group) who underwent orthopedic surgery at a university hospital between January 2023 and July 2023. Participants were randomly divided into stress ball and control groups. Patient Information Form and Visual Analogue Scale (VAS) were used to collect the data.</p></div><div><h3>Results</h3><p>It was found that the majority of the patients (55.2 %) were women and the mean age was 57.2± 18.7 years. The characteristics of the patients in the experimental and control groups were similar. The Visual Analogue Scale values of the experimental group patients at the time of injection were lower than those of the control group, which was statistically significant (<em>p</em> = 0.011). According to 68.7 % of the patients in the experimental group, the use of the stress ball reduced the intensity of pain during injection. In addition, 71.6 % of the patients were satisfied with the use of the stress ball.</p></div><div><h3>Conclusion</h3><p>It was concluded that using a stress ball helped orthopedic patients feel less pain during subcutaneous injection procedures. It was found that the experimental group's patients were mainly satisfied with the pain relief provided by stress balls.</p></div><div><h3>ClinicalTrials.gov ID</h3><p>NCT06023485</p></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"37 ","pages":"Article 100421"},"PeriodicalIF":0.0,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142048585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The compliance of sepsis resuscitation care bundle in patients diagnosed with septic shock or sepsis to the International Surviving Sepsis Campaign among patients admitted to a tertiary and teaching hospital, Ethiopia: A 1-year prospective observational study","authors":"Ruth Ayanaw Eyayu,&nbsp;Henos Enyew Ashagrie,&nbsp;Tadael Gudayu Zeleke,&nbsp;Wubie Birlie Chekol,&nbsp;Debas Yaregal Melesse","doi":"10.1016/j.pcorm.2024.100418","DOIUrl":"10.1016/j.pcorm.2024.100418","url":null,"abstract":"<div><h3>Background</h3><p>High rates of morbidity and mortality would be seen in patients suffering from sepsis and/or septic shock. It has been hypothesised that the Surviving Sepsis Campaign will reduce the morbidity and mortality of individuals who are diagnosed with septic shock and/or sepsis. Improving the surviving sepsis campaign's execution is necessary to reduce these deleterious occurrences. There is currently a lack of local data regarding the management in accordance with the guidelines in the Surviving Sepsis Campaign.Therefore, this study aimed to assess the compliance rate of sepsis resuscitation care bundle in patients diagnosed with septic shock and/or sepsis to the International Surviving Sepsis Campaign among patients admitted to a tertiary and teaching hospital, Ethiopia.</p></div><div><h3>Methods</h3><p>Hospital based, prospective observational study was conducted from January 1/2023 to December 31, 2023. Consecutive sampling technique was employed to select study participants for a period of one year and the smaple size was found to be 88 participants. A prepared checklist with standards taken from the International Surviving Sepsis Campaign was used to collect the data. Data were collected through direct-observation, interviewing the responsible physician who made the sepsis and/or septic shock diagnosis, and reviewing patient charts. Data were entered and analysed with statistical package for social sciences (SPSS) version-25.</p></div><div><h3>Results</h3><p>In treating patients diagnosed with septic shock and/or sepsis, the total compliance rate with the International Surviving Sepsis Campaign's (ISSC) sepsis resuscitation care bundle was 38 %. In the initial one-hour care bundle, 100 % of patients received the RECOMMENDED initial fluid resuscitation, 64 (72.7 %) of patients received broad spectrum antibiotics, 12 (14 %) of patients had blood culture before antibiotics.</p></div><div><h3>Conclusions</h3><p>This study concluded that sepsis resuscitation care bundle practice was subpar. Therefore, we recommend that educational training, increased awareness, and sharing the current and existing evidences are an important measures to improve the utility of the recommendations of the International Surviving Sepsis Campaign's (ISSC). After the sepsis treatment bundle has been fully implemented, a re-evaluation will take place in the summer of 2025.</p></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"37 ","pages":"Article 100418"},"PeriodicalIF":0.0,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405603024000529/pdfft?md5=a883f450ac7f7d968309291f5c09238c&pid=1-s2.0-S2405603024000529-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142048969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ventilation quality and fiber optic glottic view of AuraGain laryngeal mask in neutral, moderate, and extreme lateral head and neck positions in anesthetized spontaneously breathing children","authors":"HS Abdel-Ghaffar,&nbsp;MS Abdelmonaem,&nbsp;AH Abdel-wahab,&nbsp;MS Abbas,&nbsp;Abo SM El-yazed","doi":"10.1016/j.pcorm.2024.100413","DOIUrl":"10.1016/j.pcorm.2024.100413","url":null,"abstract":"<div><h3>Background</h3><p>We investigated the effects of moderate (45°), and extreme (60°) right lateral rotation of the head and neck on the ventilatory performance of Ambu AuraGain Laryngeal mask airway in generally anesthetized spontaneously breathing children.</p></div><div><h3>Methods</h3><p>Fifty-two children (aged 2–9 years) were randomized in this open-label observational cohort, to receive Ambu® AuraGain either in moderate (45°) (Group I, <em>n</em> = 26) or extreme (60°) (Group II, <em>n</em> = 26) lateral rotation of the head and neck. The oropharyngeal leak pressure OLP (primary outcome), ventilation score, exhaled tidal volume, and fiberoptic glottic view score, were recorded with the head and neck in a neutral position, then in lateral position after insertion by 1,15,30 and 45 min., and at end of surgery.</p></div><div><h3>Results</h3><p>The mean OLP in group I decreased from 23.81 ± 2.87 cmH2O in the neutral position to 23.77±3.78 cmH2O, (<em>P</em> = 0.941) 1 min. after lateral rotation. Whereas, In group II, it increased from 20.38 ± 4.18 cmH2O to 21.88±3.28 cmH2O, (<em>P</em> = 0.002). Afterward, the OLP was maintained decreased in group I and increased in group II (<em>P</em> &lt; 0.05), with no intergroup differences. The ventilation score did not show significant intra or inter-group differences. After lateral rotation, the fiberoptic glottic score showed a trend towards better values in group II than in group I.</p></div><div><h3>Conclusion</h3><p>Ventilation with AuraGain LMA can efficiently be implemented while the head and neck are in the neutral and laterally rotated positions in anesthetized spontaneously breathing children. Extreme lateral rotation (60°) was better tolerated than the moderate position (45°).</p></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"37 ","pages":"Article 100413"},"PeriodicalIF":0.0,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141841449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practical implementation and optimization of a clinical supply chain technology: A case report of an improvement project using a data-driven strategy","authors":"Alisha Beringer","doi":"10.1016/j.pcorm.2024.100410","DOIUrl":"10.1016/j.pcorm.2024.100410","url":null,"abstract":"<div><h3>Background</h3><p>Hospital supplies are the second largest hospital expenditure after labor cost, and management of inventory is complex. Supply management processes are often manual and reactive, lack clarity, and are overseen by both clinical and supply chain logistics teams where shared responsibilities can be challenging. Not having required supplies on-hand impacts patient safety and can encourage overstocking, potentially leading to waste when those products expire on shelves.</p></div><div><h3>Methods</h3><p>Our large hospital system noted inconsistent inventory practices leading to operating/procedural room waste, inefficiencies, staff frustration and potential risk to quality of care. A quality improvement initiative was implemented to adopt a clinical supply chain technology to track and report use, non-use, and location of supplies. We provided weekly metrics to both logistics and clinical organizations and reported quarterly progress to leadership.</p></div><div><h3>Results</h3><p>Across 37 surgical and procedural departments within 11 hospitals, our quality improvement initiative improved our product expiration by 78 <strong>%</strong> and supply waste by 50 <strong>%</strong> with an 11 <strong>%</strong> reduction in owned inventory. It also built strong relationships between clinical and logistics and supported comprehensive patient charge capture for supplies.</p></div><div><h3>Conclusion</h3><p>Using data-driven strategies we gained visibility and leveraged data to increase efficiency and reduce waste enabling our organization's supply chain to move from reactive to proactive. This case report describes the implementation and optimization of our clinical supply chain technology, and how the combination of people, processes, and technology transformed our supply chain, bridging the gap between our clinical and logistics organizations.</p></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"35 ","pages":"Article 100410"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S240560302400044X/pdfft?md5=bc57fa8315359004b8d2541c178f191d&pid=1-s2.0-S240560302400044X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141850672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of postoperative results after hemorrhoidectomy under local and spinal anesthesia","authors":"Nguyen Trung Vo ,&nbsp;Viet Tung Le ,&nbsp;Quoc Vinh Nguyen ,&nbsp;Tan Thanh Nguyen ,&nbsp;Manh Tuan Ha","doi":"10.1016/j.pcorm.2024.100402","DOIUrl":"https://doi.org/10.1016/j.pcorm.2024.100402","url":null,"abstract":"<div><h3>Background</h3><p>Hemorrhoidectomy is commonly performed under general or regional anesthesia; nevertheless, the underutilization of local anesthesia is attributed to safety concerns. The aim of this study was to compare postoperative outcomes following hemorrhoidectomy using local anesthesia and spinal anesthesia.</p></div><div><h3>Methods</h3><p>This study was a retrospective cohort study, conducted at the General Surgery Department of the University Medical Center Ho Chi Minh City Branch 2 from January 2018 to September 2023, focused on Milligan-Morgan hemorrhoidectomies for third or fourth-degree hemorrhoids.</p></div><div><h3>Results</h3><p>A total of 114 patients with third or fourth-degree hemorrhoids were included in the study, with 59 patients in the local anesthesia group and 55 patients in the spinal anesthesia group. Throughout all three time points, average pain scores were consistently lower in the local anesthesia group. The average recovery time for the local anesthesia group was 8.34 ± 6.17 days, and for the spinal anesthesia group, it was 10.50 ± 7.01 days. However, these differences were not statistically significant (p &gt; 0.05). Notably, the local anesthesia group exhibited a significantly lower rate of postoperative complications compared to the spinal anesthesia group (0 % versus 5.5 %, respectively). Additionally, the local anesthesia group had a significantly shorter length of stay (11.07 ± 15.81 h) and lower medical costs (7,793,187 ± 1,835,713 VND) compared to the spinal anesthesia group (32.87 ± 26.06 h and 9,468,098 ± 2,883,630 VND, respectively).</p></div><div><h3>Conclusions</h3><p>Hemorrhoidectomy under local anesthesia is feasible and safe, and local anesthesia may be considered as an alternative to spinal anesthesia in some cases.</p></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"35 ","pages":"Article 100402"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141324316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increasing first case on time starts in the operating room using an electronic readiness dashboard: A quality improvement project","authors":"Crystal Knox,&nbsp;Joseph Harper,&nbsp;Leanne McMillan,&nbsp;Brooke Vining,&nbsp;Tracie White","doi":"10.1016/j.pcorm.2024.100412","DOIUrl":"10.1016/j.pcorm.2024.100412","url":null,"abstract":"<div><h3>Introduction</h3><p>First case surgical delays cause domino effects resulting in subsequent case delays, staff overtime pay, and patient dissatisfaction. A total of 23,690 min were lost during March to June 2022. The project goal was to implement the surgical enhanced readiness dashboard (SERD) to increase efficiency, resulting in the increased first case on-time starts (FCOTS) by 5 % in the March-June/fiscal year (FY) 2022 versus March-June/FY 2021.</p></div><div><h3>Materials/Methods</h3><p>FCOTS were captured by an institutional data analysis program. Data was pulled from the electronic health record from when the nurse recorded time the in the operating room (OR) time. A pre-and post-implementation survey was distributed to OR nurses and analyzed. Data was collected for one quarter and compared to the previous year's quarter. A statistical T-test was used to compare the pre-and post-implementation data and the pre-and post-implementation surveys.</p></div><div><h3>Theory/Calculation</h3><p>The Donabedian Model evaluated the safety and quality of the SERD's structure, process, and outcome. Data collected from the project provided quality metrics that led to transformative change.</p></div><div><h3>Results</h3><p>Of the 35 anonymous surveys submitted, 54.3 % of participants value using the SERD as a surgical readiness tool to improve their workflow. FCOTS during the implementation period of FY 2022 March-June averaged 72.3 %, an overall increase of 0.6 % of the same time frame in FY 2021 (71.7 %).</p></div><div><h3>Discussion</h3><p>The SERD's central location in the preoperative area and incorporation into the nursing workflow standardize the preoperative process and bridge communication gaps between nurses, anesthesia, residents, and surgeons. Efficient transitions through the preoperative area decrease healthcare organizations' overall costs.</p></div><div><h3>Conclusion</h3><p>Delays in patient surgery are costly to healthcare organizations. Patients scheduled for first surgical cases arrive early and expect to be prepared for surgery efficiently. Implementing an electronic dashboard to increase the number of FCOTS will be instrumental in streamlining patients throughout the perioperative stay. The data collected will help drive perioperative nurses to decrease costly delays in patient care.</p></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"35 ","pages":"Article 100412"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141845710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scaling performance frontiers across multiple perioperative services","authors":"Erik J. Zhang ,&nbsp;Roya Saffary ,&nbsp;Soniya Sharma ,&nbsp;Joshua M. Hagood ,&nbsp;Andrea J. Elhajj ,&nbsp;Mitchell H. Tsai","doi":"10.1016/j.pcorm.2024.100407","DOIUrl":"10.1016/j.pcorm.2024.100407","url":null,"abstract":"<div><h3>Background</h3><p>One of the primary principles governing operating room management includes maximizing clinical efficiency and optimizing the time used in the high-cost, high-revenue environments represented by operating rooms. Under-utilized and over-utilized times are elementary metrics that describe the operating room performance. Performance frontiers, the graphical representation of a hypothetical maximum performance of a manufacturing unit given a set of operating choices, visualize the maximal efficiency of systems and their existing constraints.</p></div><div><h3>Methods</h3><p>Monthly aggregated operating room metrics from services at the University of Vermont Medical Center (UVM), Stanford Hospital, and the University of Alabama (UAB) at Birmingham Hospital were extracted. Paired under- and over-utilized times were plotted against each other. Performance frontiers representing the optimal performance of each service were overlaid.</p></div><div><h3>Results</h3><p>The Kolmogorov-Smirnov test for goodness-of-fit at 95 % level of significance confirms that the performance frontiers representing UVM and Stanford (K-<em>S</em> = 0.9507, <em>p</em> &lt; 0.0001), UVM and UAB (K-<em>S</em> = 0.9989, <em>p</em> &lt; 0.0001), and Stanford and UAB (K-<em>S</em> = 0.9773, <em>p</em> &lt; 0.0001), indicating each service is represented by a different performance frontier.</p></div><div><h3>Conclusions</h3><p>Our analysis shows that the performance frontier defining the optimal efficiency of UVM is more efficient than that of Stanford and UAB. Differences in efficiency may be the result of a collection of factors that must be the subject of future research, including but not limited to organizational differences limited in scale of institutions. Choices in operating room management must be made in relation to the existing organizational structures of each institution and their specific capacity to make changes in tactical decisions. Systemic interventions should be implemented via qualitative analysis of more efficient services, defined by the relative positioning of relevant performance frontiers.</p></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"35 ","pages":"Article 100407"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141690716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}