PD32-09 GOAL SETTING AND OR TURNOVER TIME: A RANDOMIZED TRIAL

Abstract

You have accessJournal of UrologyCME1 Apr 2023PD32-09 GOAL SETTING AND OR TURNOVER TIME: A RANDOMIZED TRIAL Ethan Matz, Rahul Dutta, Matvey Tsivian, Ryan Terlecki, and Catherine Matthews Ethan MatzEthan Matz More articles by this author , Rahul DuttaRahul Dutta More articles by this author , Matvey TsivianMatvey Tsivian More articles by this author , Ryan TerleckiRyan Terlecki More articles by this author , and Catherine MatthewsCatherine Matthews More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003325.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Longer operating room (OR) turnover times negatively impacts hospital costs, surgeon volume, and satisfaction. Our published institutional turnover times are 30 minutes for outpatient and 40 minutes for inpatient cases. The primary aim of this randomized trial was to examine the impact of a verbalized time goal for room re-entry compared to usual care. Secondary aims were to evaluate risk factors for turnover times that exceeded specified institutional standards. METHODS: This is a prospective, single blind, randomized study in which sequential cases were randomized to receiving a verbal prompt with the goal OR return time by the attending surgeon versus usual care. Block randomization that controlled for inpatient versus outpatient OR location was administered through random sequential number generation in RedCap. From the electronic medical record, we captured data regarding turnover time, location, case type (robotic, open, transvaginal), OR staff team make-up, case order, and surgeon gender. A logistic regression analysis that controlled for location, case type, surgeon, and case order was performed to assess risk factors for prolonged turnover times. A standard power analysis was performed. RESULTS: From July through October 2022, 5 attending surgeons randomized 86 cases: 40 cases to verbal prompt vs 46 to usual care. Of these, 30 were inpatient and 56 outpatient and case mix included 8% open, 8% robotic, 36% transvaginal, 26% endoscopic and 22% other. Overall, mean inpatient and outpatient turnover time were longer than the stated institutional goals: 51.7 minutes compared to 40 minutes, and 34.8 minutes compared to 30 minutes, respectively. 30% of inpatient and 49% of outpatient cases hit the institutional goals (p=0.088). For the highest accruing surgeon, verbal prompting significantly decreased OR turnover time (33 vs 43 min, p=0.04). Vaginal surgery specifically trended towards having faster turnover time with prompting (40 vs 33 min, p=0.088). With a logistic regression model controlling for location, staff, surgeon, surgeon gender, case type, and verbal prompt, only verbal prompting was independently associated with reaching the goal turnover time (OR=3.96 [1.05-15.02], p=0.0426). CONCLUSIONS: In this prospective, single blind study, verbal instruction by the attending surgeon is independently associated with successfully reaching institutionally directed turnover times. This is a low-cost intervention that requires further study in a larger cohort. Source of Funding: N/A © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e910 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ethan Matz More articles by this author Rahul Dutta More articles by this author Matvey Tsivian More articles by this author Ryan Terlecki More articles by this author Catherine Matthews More articles by this author Expand All Advertisement PDF downloadLoading ...