The addition of a regional block team to the orthopedic operating rooms does not improve anesthesia-controlled times and turnover time in the setting of long turnover times

• Published in: Journal of clinical anesthesia 2007-03, Vol.19 (2), p.85-91
• Main Authors: Eappen, Sunil, MD, Flanagan, Hugh, MD, Lithman, Rachel, Bhattacharyya, Neil, MD
• Format: Article
• Language: English
• Subjects: Anesthesia; Anesthesia & Perioperative Care; Anesthesia Recovery Period; Anesthesia, Conduction - economics; Anesthesia, Conduction - methods; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Appointments and Schedules; Attitude of Health Personnel; Biological and medical sciences; Bone surgery; Contract negotiations; Cost control; Efficiency; Hospitals; Hospitals, Teaching - economics; Hospitals, Teaching - organization & administration; Humans; Massachusetts; Medical sciences; Nerve Block - economics; Nerve Block - methods; Operating Room Information Systems; Operating room management; Operating Rooms - economics; Operating Rooms - organization & administration; Orthopedic Procedures - methods; Orthopedics; Pain Medicine; Patient Care Team - economics; Patient Care Team - organization & administration; Prospective Studies; Regional; Time Factors; Turnover times
• ISSN: 0952-8180; 1873-4529
• DOI: 10.1016/j.jclinane.2006.04.010

Abstract Study Objective To determine whether a regional block team with a dedicated space for performance of regional anesthetics would decrease turnover time and shorten the working day in a busy orthopedic practice with lengthy turnover times. Design Prospective, randomized study. Setting Tertiary-care teaching hospital. Patients 927 orthopedic procedures over a three-month period. Interventions The randomized placement of a regional block team to the orthopedic operating room (OR) suite. Measurements We evaluated the differences in anesthesia-controlled times, first-case start times, turnover times, and OR end times using a computerized OR information system. We also surveyed the surgeons regarding their perceptions of changes in turnover time and anesthesia-controlled times during the study period. Standard descriptive statistics were computed. Results Of a total of 927 cases, 398 cases were cared for by a regional block team and 529 cases received care in the usual manner, with the OR team providing the regional block. There was no difference between the study and control groups for on-time, first-case starts (57.73% vs 42.27%), induction time (13.2 vs 14.2 min), emergence time (8.1 vs 9.0 min), turnover time (70.3 vs 77.8 min), and OR end times. Most of the surgeons surveyed felt that the regional block team reduced turnover time significantly. Conclusion A regional block team in this environment does not reduce anesthesia-controlled times and turnover times in an orthopedic OR suite with long turnover times, and it would be virtually impossible to recover the associated extra cost. The surgeons' perspective of turnover time is inaccurate.