High efficiency endocrine operation protocol: From design to implementation

Background We developed a high efficiency endocrine operative protocol based on a mathematical programming approach, process reengineering, and value-stream mapping to increase the number of operations completed per day without increasing operating room time at a tertiary-care, academic center. Meth...

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Bibliographic Details
Published in:Surgery 2016-10, Vol.160 (4), p.1118-1124
Main Authors: Mascarella, Marco A., MD, Lahrichi, Nadia, PhD, Cloutier, Fabienne, RN, Kleiman, Simcha, MD, FRCPC, Payne, Richard J., MD, MSc, FRCSC, Rosenberg, Lawrence, MD, PhD, FRCSC
Format: Article
Language:English
Subjects:
Academic Medical Centers - standards
Adult
Canada
Case-Control Studies
Efficiency, Organizational
Female
Humans
Length of Stay
Male
Middle Aged
Models, Theoretical
Operating Rooms - organization & administration
Operative Time
Parathyroidectomy - standards
Parathyroidectomy - trends
Perioperative Care
Postoperative Complications - epidemiology
Postoperative Complications - prevention & control
Process Assessment (Health Care)
Reference Standards
Surgery
Thyroidectomy - standards
Thyroidectomy - trends
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Summary:Background We developed a high efficiency endocrine operative protocol based on a mathematical programming approach, process reengineering, and value-stream mapping to increase the number of operations completed per day without increasing operating room time at a tertiary-care, academic center. Methods Using this protocol, a case-control study of 72 patients undergoing endocrine operation during high efficiency days were age, sex, and procedure-matched to 72 patients undergoing operation during standard days. The demographic profile, operative times, and perioperative complications were noted. Results The average number of cases per 8-hour workday in the high efficiency and standard operating rooms were 7 and 5, respectively. Mean procedure times in both groups were similar. The turnaround time (mean ± standard deviation) in the high efficiency group was 8.5 (±2.7) minutes as compared with 15.4 (±4.9) minutes in the standard group ( P  
ISSN:0039-6060
1532-7361
DOI:10.1016/j.surg.2016.06.037