An assessment of the quality indicators of operative and non-operative times in a public university hospital.

Altair da Silva Costa Jr,Luiz Eduardo Villaça Leão,Maykon Anderson Pires de Novais,Paola Zucchi

doi:10.1590/s1679-45082015gs3289

Altair da Silva Costa Jr, Luiz Eduardo Villaça Leão + Show 2 more

Open Access

https://doi.org/10.1590/s1679-45082015gs3289

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Abstract

ABSTRACTObjective To assess the operative time indicators in a public university hospital.Methods A descriptive cross-sectional study was conducted using data from operating room database. The sample was obtained from January 2011 to January 2012. The operations performed in sequence in the same operating room, between 7:00 am and 5:00 pm, elective or emergency, were included. The procedures with incomplete data in the system were excluded, as well as the operations performed after 5:00 pm or on weekends or holidays.Results We measured the operative and non-operative time of 8,420 operations. The operative time (mean and standard deviation) of anesthesias and operations were 177.6±110 and 129.8±97.1 minutes, respectively. The total time of the patient in operative room (mean and standard deviation) was 196.8±113.2. The non-operative time, e.g., between the arrival of the patient and the onset of anesthesia was 14.3±17.3 minutes. The time to set the next patient in operating room was 119.8±79.6 minutes. Our total non-operative time was 155 minutes.Conclusion Delays frequently occurred in our operating room and had a major effect on patient flow and resource utilization. The non-operative time was longer than the operative time. It is possible to increase the operating room capacity by management and training of the professionals involved. The indicators provided a tool to improve operating room efficiency.

Highlights

In the United States, 15 million surgical procedures have been done (495 procedures/10 thousand inhabitants), with hospital costs of approximately US$ 171 billion
There are patients referred from the emergency room, intensive care unit, inpatients units, and who came from home, as well as elective, and urgency or emergency operations
The professionals who work in the sector have different characteristics that varies by specialty, e.g., a surgery for cataracts correction and a heart transplantation have different logistics and are performed within the same environment

Summary

INTRODUCTION

In the United States, 15 million surgical procedures have been done (495 procedures/10 thousand inhabitants), with hospital costs of approximately US$ 171 billion. The operating room (OR) should be efficient and optimized, as well as the available time and resources.[1,2,3]. The OR is one of the most complex structures of the hospital system: it functions 24 hours a day, seven days a week, and there is a difference in complexity in terms of equipment and procedures. It needs several classes of professionals – administrator, physicians, nurses, information technology, pharmacists, cleaning employees, among others. Its organization (or lack of), the cost of an idle OR, and the exhaustion of the professionals are examples of wasted time and resources that affect the patient, family members, the hospital, and the professionals.[11,12]

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CONCLUSION