In Reply:

Abstract

We would first like to thank Dr Hahn and colleagues for taking the time to comment on our study and share their experience.We have no disagreement that the operating room (OR) staffs’ effect on turnover time (TT) is only 1 variable contributing to OR efficiency.1Avery III, D.M. Matullo K.S. The efficiency of a dedicated staff on operating room turnover time in hand surgery.J Hand Surg Am. 2013; 39: 108-110Abstract Full Text Full Text PDF PubMed Scopus (29) Google Scholar However, we believe it has been controlled for adequately in our study.We understand Dr Hahn and colleagues’ reasoning for having a different measurement of TT. However, in our study, to isolate the effect of OR staff on room turnover, it was important to begin with the time the previous patient left the OR to the time the next patient entered. This TT definition eliminates confounding variables, including wound closure, dressing application, in-room time to awaken the patient, and patient movement off the OR table. We eliminated first-case starts to address further variables such as staff lateness, and began analysis after the first surgery. Also, all evaluated surgeries were soft tissue procedures, which require opening 1 table pack, 1 suture, and 1 tray of instruments. This narrowed case selection helped to eliminate the variable of required items to be opened before patient arrival. Dr Hahn and coworkers highlight that anesthesia preparation and efficiency also effect TT and efficiency, and we agree.We also agree that future projects could consist of measuring the effect of OR staff on TT with a broader inclusion of cases such as microscopic surgery, as well as evaluating the effect of both the type of anesthesia and the efficiency of the anesthesia team on TT. The effect of dedicated staff in cases with complex equipment2Lasser M.S. Patel C.K. Elsamra S.E. Renzulli Jr., J.F. Haleblian G.E. Pareek G. Dedicated robotics team reduces pre-surgical preparation time.Ind J Urol. 2012; 28: 263-266Crossref PubMed Scopus (16) Google Scholar has been demonstrated, and although we believe this could be comparable to hand surgery, it could be reevaluated. Inclusion of a wider variety of procedures and multiple surgeons, and performing a cost model analysis would increase understanding of OR efficiency and are areas for future research. We would first like to thank Dr Hahn and colleagues for taking the time to comment on our study and share their experience. We have no disagreement that the operating room (OR) staffs’ effect on turnover time (TT) is only 1 variable contributing to OR efficiency.1Avery III, D.M. Matullo K.S. The efficiency of a dedicated staff on operating room turnover time in hand surgery.J Hand Surg Am. 2013; 39: 108-110Abstract Full Text Full Text PDF PubMed Scopus (29) Google Scholar However, we believe it has been controlled for adequately in our study. We understand Dr Hahn and colleagues’ reasoning for having a different measurement of TT. However, in our study, to isolate the effect of OR staff on room turnover, it was important to begin with the time the previous patient left the OR to the time the next patient entered. This TT definition eliminates confounding variables, including wound closure, dressing application, in-room time to awaken the patient, and patient movement off the OR table. We eliminated first-case starts to address further variables such as staff lateness, and began analysis after the first surgery. Also, all evaluated surgeries were soft tissue procedures, which require opening 1 table pack, 1 suture, and 1 tray of instruments. This narrowed case selection helped to eliminate the variable of required items to be opened before patient arrival. Dr Hahn and coworkers highlight that anesthesia preparation and efficiency also effect TT and efficiency, and we agree. We also agree that future projects could consist of measuring the effect of OR staff on TT with a broader inclusion of cases such as microscopic surgery, as well as evaluating the effect of both the type of anesthesia and the efficiency of the anesthesia team on TT. The effect of dedicated staff in cases with complex equipment2Lasser M.S. Patel C.K. Elsamra S.E. Renzulli Jr., J.F. Haleblian G.E. Pareek G. Dedicated robotics team reduces pre-surgical preparation time.Ind J Urol. 2012; 28: 263-266Crossref PubMed Scopus (16) Google Scholar has been demonstrated, and although we believe this could be comparable to hand surgery, it could be reevaluated. Inclusion of a wider variety of procedures and multiple surgeons, and performing a cost model analysis would increase understanding of OR efficiency and are areas for future research. Identifying Parameters That Influence Efficiency of Surgical ProceduresJournal of Hand SurgeryVol. 39Issue 4PreviewWe agree with authors Avery and Matullo1 that efficiency in the operation room is of current interest. Full-Text PDF