High-throughput Operating Room System for Joint Arthroplasties Durably Outperforms Routine Processes

• DOI: 10.1097/aln.0b013e31817881c7
• Publication Date: 2009-03-05T18:10:34Z
• Authors: Michael P. Smith; Warren S. Sandberg; Joseph Foss; Kathleen Massoli; Mona Kanda; Wael Barsoum; Armin Schubert
• Keywords: Aged, 80 and over; Male; Operating Rooms; Time Factors; Time Management; Middle Aged; Efficiency, Organizational; Arthroplasty; Personnel, Hospital; Appointments and Schedules; 03 medical and health sciences; 0302 clinical medicine; Humans; Anesthesia; Female; Aged; Retrospective Studies

Background Recent publications have focused on increased operating room (OR) throughput without increasing total OR time. The authors hypothesized that a system of parallel processing for lower extremity joint arthroplasties sustainably reduces nonoperative time and increases throughput. Methods high-throughput strategy included neuraxial anesthesia performed in an "induction room" adjacent to the OR, patient selection, additional circulating nurse, end-of-case transfer care recovery nurse who transported from recovery. Instruments supplies were prepared dedicated sterile setup area. Data extracted administrative databases. Group comparisons used standard statistical methods; process control was evaluate performance over Results There 688 historic cases 299 days 16 months, 905 304 spanning 24 consecutive months starting September 1, 2004. Throughput 2.6 +/- 0.7 (mean SD) 3.4 0.8 per day room. Nonoperative decreased by 36 min (or 50%) case. Operative also 14 (12%) end only later than control. time, operative remained significantly improved after 2 yr operation. Contribution margin 19.6%. Conclusion Reorganizing perioperative work replacements Because generated positive greater incremental cost, financial performance.