Charles Fleming, Christian Terwiesch, John Reavey-Cantwell
{"title":"连续堆叠类似的神经内血管病例可缩短周转时间和手术时间。","authors":"Charles Fleming, Christian Terwiesch, John Reavey-Cantwell","doi":"10.1136/jnis-2024-022218","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Across a wide range of tasks it has been shown that workers switching between different activities have 'switching costs' due to slower performance and increased errors. Scheduling similar cases consecutively, or 'stacking cases', allows an operating room (OR) team to avoid switching costs and might therefore result in increased efficiency.</p><p><strong>Objective: </strong>To investigate whether stacking neuroendovascular cases decreases turnover and procedure time.</p><p><strong>Methods: </strong>A retrospective case series was identified of 4386 endovascular cases performed by vascular neurosurgeons between 2015 and 2023 at an academic center. A 'stacked case' was defined as a binary variable, which counted as 'yes' when the preceding case was the same procedure. Primary outcomes were turnover time and procedure time.</p><p><strong>Results: </strong>Diagnostic angiograms (n=2575) and aneurysm embolizations (n=517) had a sufficient number of cases for statistical analysis.Stacked diagnostic angiograms were associated with significantly faster turnover time (7 min, P=1e-12) in a multivariate regression model. Turnover time decreased with additional stacked cases, with a 4 min reduction for a single stacked case, up to 11 min for a fifth stacked angiogram.For angiograms and aneurysm embolizations, stacked cases were associated with shorter procedure times: 4 min for angiograms (P<0.0001) and 20 min for aneurysm embolizations (P=0.0057).</p><p><strong>Conclusion: </strong>This project demonstrates that stacking similar cases is associated with reduced turnover and procedure time, after controlling for other variables that affect the flow of an OR day. Stacking cases is a zero-cost intervention that offers significant efficiency gains in the OR schedule.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":null,"pages":null},"PeriodicalIF":4.5000,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Stacking consecutive similar neuroendovascular cases is associated with reduced turnover time and procedure time.\",\"authors\":\"Charles Fleming, Christian Terwiesch, John Reavey-Cantwell\",\"doi\":\"10.1136/jnis-2024-022218\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Across a wide range of tasks it has been shown that workers switching between different activities have 'switching costs' due to slower performance and increased errors. Scheduling similar cases consecutively, or 'stacking cases', allows an operating room (OR) team to avoid switching costs and might therefore result in increased efficiency.</p><p><strong>Objective: </strong>To investigate whether stacking neuroendovascular cases decreases turnover and procedure time.</p><p><strong>Methods: </strong>A retrospective case series was identified of 4386 endovascular cases performed by vascular neurosurgeons between 2015 and 2023 at an academic center. A 'stacked case' was defined as a binary variable, which counted as 'yes' when the preceding case was the same procedure. Primary outcomes were turnover time and procedure time.</p><p><strong>Results: </strong>Diagnostic angiograms (n=2575) and aneurysm embolizations (n=517) had a sufficient number of cases for statistical analysis.Stacked diagnostic angiograms were associated with significantly faster turnover time (7 min, P=1e-12) in a multivariate regression model. Turnover time decreased with additional stacked cases, with a 4 min reduction for a single stacked case, up to 11 min for a fifth stacked angiogram.For angiograms and aneurysm embolizations, stacked cases were associated with shorter procedure times: 4 min for angiograms (P<0.0001) and 20 min for aneurysm embolizations (P=0.0057).</p><p><strong>Conclusion: </strong>This project demonstrates that stacking similar cases is associated with reduced turnover and procedure time, after controlling for other variables that affect the flow of an OR day. Stacking cases is a zero-cost intervention that offers significant efficiency gains in the OR schedule.</p>\",\"PeriodicalId\":16411,\"journal\":{\"name\":\"Journal of NeuroInterventional Surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.5000,\"publicationDate\":\"2024-08-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of NeuroInterventional Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1136/jnis-2024-022218\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"NEUROIMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of NeuroInterventional Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/jnis-2024-022218","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NEUROIMAGING","Score":null,"Total":0}
Stacking consecutive similar neuroendovascular cases is associated with reduced turnover time and procedure time.
Background: Across a wide range of tasks it has been shown that workers switching between different activities have 'switching costs' due to slower performance and increased errors. Scheduling similar cases consecutively, or 'stacking cases', allows an operating room (OR) team to avoid switching costs and might therefore result in increased efficiency.
Objective: To investigate whether stacking neuroendovascular cases decreases turnover and procedure time.
Methods: A retrospective case series was identified of 4386 endovascular cases performed by vascular neurosurgeons between 2015 and 2023 at an academic center. A 'stacked case' was defined as a binary variable, which counted as 'yes' when the preceding case was the same procedure. Primary outcomes were turnover time and procedure time.
Results: Diagnostic angiograms (n=2575) and aneurysm embolizations (n=517) had a sufficient number of cases for statistical analysis.Stacked diagnostic angiograms were associated with significantly faster turnover time (7 min, P=1e-12) in a multivariate regression model. Turnover time decreased with additional stacked cases, with a 4 min reduction for a single stacked case, up to 11 min for a fifth stacked angiogram.For angiograms and aneurysm embolizations, stacked cases were associated with shorter procedure times: 4 min for angiograms (P<0.0001) and 20 min for aneurysm embolizations (P=0.0057).
Conclusion: This project demonstrates that stacking similar cases is associated with reduced turnover and procedure time, after controlling for other variables that affect the flow of an OR day. Stacking cases is a zero-cost intervention that offers significant efficiency gains in the OR schedule.
期刊介绍:
The Journal of NeuroInterventional Surgery (JNIS) is a leading peer review journal for scientific research and literature pertaining to the field of neurointerventional surgery. The journal launch follows growing professional interest in neurointerventional techniques for the treatment of a range of neurological and vascular problems including stroke, aneurysms, brain tumors, and spinal compression.The journal is owned by SNIS and is also the official journal of the Interventional Chapter of the Australian and New Zealand Society of Neuroradiology (ANZSNR), the Canadian Interventional Neuro Group, the Hong Kong Neurological Society (HKNS) and the Neuroradiological Society of Taiwan.