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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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| Published in: | Surgery 2016-10, Vol.160 (4), p.1118-1124 |
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| container_title | Surgery |
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| creator | 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 |
| description | 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 |
| doi_str_mv | 10.1016/j.surg.2016.06.037 |
| format | article |
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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 < .001). Transient postoperative hypocalcemia was 6.9% (5/72) and 8.3% (6/72) for the high efficiency and standard groups, respectively ( P = .99). Conclusion In this study, patients undergoing high efficiency endocrine operation had similar procedure times and perioperative complications compared with the standard group. The proposed high efficiency protocol seems to better utilize operative time and decrease the backlog of patients waiting for endocrine operation in a country with a universal national health care program.</description><identifier>ISSN: 0039-6060</identifier><identifier>EISSN: 1532-7361</identifier><identifier>DOI: 10.1016/j.surg.2016.06.037</identifier><identifier>PMID: 27521046</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>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</subject><ispartof>Surgery, 2016-10, Vol.160 (4), p.1118-1124</ispartof><rights>Elsevier Inc.</rights><rights>2016 Elsevier Inc.</rights><rights>Copyright © 2016 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-94a4bbea9ed1b5343aafcf103668fc49b24f872059a7c6b315b7a98b8d0d77133</citedby><cites>FETCH-LOGICAL-c411t-94a4bbea9ed1b5343aafcf103668fc49b24f872059a7c6b315b7a98b8d0d77133</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27521046$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mascarella, Marco A., MD</creatorcontrib><creatorcontrib>Lahrichi, Nadia, PhD</creatorcontrib><creatorcontrib>Cloutier, Fabienne, RN</creatorcontrib><creatorcontrib>Kleiman, Simcha, MD, FRCPC</creatorcontrib><creatorcontrib>Payne, Richard J., MD, MSc, FRCSC</creatorcontrib><creatorcontrib>Rosenberg, Lawrence, MD, PhD, FRCSC</creatorcontrib><title>High efficiency endocrine operation protocol: From design to implementation</title><title>Surgery</title><addtitle>Surgery</addtitle><description>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 < .001). Transient postoperative hypocalcemia was 6.9% (5/72) and 8.3% (6/72) for the high efficiency and standard groups, respectively ( P = .99). Conclusion In this study, patients undergoing high efficiency endocrine operation had similar procedure times and perioperative complications compared with the standard group. The proposed high efficiency protocol seems to better utilize operative time and decrease the backlog of patients waiting for endocrine operation in a country with a universal national health care program.</description><subject>Academic Medical Centers - standards</subject><subject>Adult</subject><subject>Canada</subject><subject>Case-Control Studies</subject><subject>Efficiency, Organizational</subject><subject>Female</subject><subject>Humans</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Models, Theoretical</subject><subject>Operating Rooms - organization & administration</subject><subject>Operative Time</subject><subject>Parathyroidectomy - standards</subject><subject>Parathyroidectomy - trends</subject><subject>Perioperative Care</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - prevention & control</subject><subject>Process Assessment (Health Care)</subject><subject>Reference Standards</subject><subject>Surgery</subject><subject>Thyroidectomy - standards</subject><subject>Thyroidectomy - trends</subject><subject>Waiting Lists</subject><issn>0039-6060</issn><issn>1532-7361</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><recordid>eNp9kU1v1DAQhi0EokvhD3BAOXLJMmM7H0YICVUtrajEAThbjjNZvCT2YidI--_rdAsHDpVGsg_P-8p-hrHXCFsErN_tt2mJuy3P9y3kEc0TtsFK8LIRNT5lGwChyhpqOGMvUtoDgJLYPmdnvKk4gqw37Mu12_0saBicdeTtsSDfBxudpyIcKJrZBV8cYpiDDeP74iqGqegpuZ0v5lC46TDSRH6-516yZ4MZE716OM_Zj6vL7xfX5e3XzzcXn25LKxHnUkkju46Moh67SkhhzGAHBFHX7WCl6rgc2oZDpUxj605g1TVGtV3bQ980KMQ5e3vqze_6vVCa9eSSpXE0nsKSNLaopACuVEb5CbUxpBRp0IfoJhOPGkGvEvVerxL1KlFDHtHk0JuH_qWbqP8X-WstAx9OAOVf_nEUdbq3R72LZGfdB_d4_8f_4nZ03lkz_qIjpX1Yos_-NOrENehv6xrXLWItQHCO4g7IlZhc</recordid><startdate>20161001</startdate><enddate>20161001</enddate><creator>Mascarella, Marco A., MD</creator><creator>Lahrichi, Nadia, PhD</creator><creator>Cloutier, Fabienne, RN</creator><creator>Kleiman, Simcha, MD, FRCPC</creator><creator>Payne, Richard J., MD, MSc, FRCSC</creator><creator>Rosenberg, Lawrence, MD, PhD, FRCSC</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20161001</creationdate><title>High efficiency endocrine operation protocol: From design to implementation</title><author>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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-94a4bbea9ed1b5343aafcf103668fc49b24f872059a7c6b315b7a98b8d0d77133</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Academic Medical Centers - standards</topic><topic>Adult</topic><topic>Canada</topic><topic>Case-Control Studies</topic><topic>Efficiency, Organizational</topic><topic>Female</topic><topic>Humans</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Models, Theoretical</topic><topic>Operating Rooms - organization & administration</topic><topic>Operative Time</topic><topic>Parathyroidectomy - standards</topic><topic>Parathyroidectomy - trends</topic><topic>Perioperative Care</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - prevention & control</topic><topic>Process Assessment (Health Care)</topic><topic>Reference Standards</topic><topic>Surgery</topic><topic>Thyroidectomy - standards</topic><topic>Thyroidectomy - trends</topic><topic>Waiting Lists</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mascarella, Marco A., MD</creatorcontrib><creatorcontrib>Lahrichi, Nadia, PhD</creatorcontrib><creatorcontrib>Cloutier, Fabienne, RN</creatorcontrib><creatorcontrib>Kleiman, Simcha, MD, FRCPC</creatorcontrib><creatorcontrib>Payne, Richard J., MD, MSc, FRCSC</creatorcontrib><creatorcontrib>Rosenberg, Lawrence, MD, PhD, FRCSC</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mascarella, Marco A., MD</au><au>Lahrichi, Nadia, PhD</au><au>Cloutier, Fabienne, RN</au><au>Kleiman, Simcha, MD, FRCPC</au><au>Payne, Richard J., MD, MSc, FRCSC</au><au>Rosenberg, Lawrence, MD, PhD, FRCSC</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>High efficiency endocrine operation protocol: From design to implementation</atitle><jtitle>Surgery</jtitle><addtitle>Surgery</addtitle><date>2016-10-01</date><risdate>2016</risdate><volume>160</volume><issue>4</issue><spage>1118</spage><epage>1124</epage><pages>1118-1124</pages><issn>0039-6060</issn><eissn>1532-7361</eissn><abstract>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 < .001). Transient postoperative hypocalcemia was 6.9% (5/72) and 8.3% (6/72) for the high efficiency and standard groups, respectively ( P = .99). Conclusion In this study, patients undergoing high efficiency endocrine operation had similar procedure times and perioperative complications compared with the standard group. The proposed high efficiency protocol seems to better utilize operative time and decrease the backlog of patients waiting for endocrine operation in a country with a universal national health care program.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>27521046</pmid><doi>10.1016/j.surg.2016.06.037</doi><tpages>7</tpages></addata></record> |
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| 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 |
| title | High efficiency endocrine operation protocol: From design to implementation |
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