High efficiency endocrine operation protocol: From design to implementation

• 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; Waiting Lists
• ISSN: 0039-6060; 1532-7361
• DOI: 10.1016/j.surg.2016.06.037

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