A comparison between a maximum care university hospital and an outpatient clinic – potential for optimization in arthroscopic workflows?
Abstract Background Due to the growing economic pressure, there is an increasing interest in the optimization of operational processes within surgical operating rooms (ORs). Surgical departments are frequently dealing with limited resources, complex processes with unexpected events as well as consta...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-11-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-023-10259-3 |
| _version_ | 1827604021675819008 |
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| author | Martin Schenk Juliane Neumann Nadine Adler Tilo Trommer Jan Theopold Thomas Neumuth Pierre Hepp |
| author_facet | Martin Schenk Juliane Neumann Nadine Adler Tilo Trommer Jan Theopold Thomas Neumuth Pierre Hepp |
| author_sort | Martin Schenk |
| collection | DOAJ |
| description | Abstract Background Due to the growing economic pressure, there is an increasing interest in the optimization of operational processes within surgical operating rooms (ORs). Surgical departments are frequently dealing with limited resources, complex processes with unexpected events as well as constantly changing conditions. In order to use available resources efficiently, existing workflows and processes have to be analyzed and optimized continuously. Structural and procedural changes without prior data-driven analyses may impair the performance of the OR team and the overall efficiency of the department. The aim of this study is to develop an adaptable software toolset for surgical workflow analysis and perioperative process optimization in arthroscopic surgery. Methods In this study, the perioperative processes of arthroscopic interventions have been recorded and analyzed subsequently. A total of 53 arthroscopic operations were recorded at a maximum care university hospital (UH) and 66 arthroscopic operations were acquired at a special outpatient clinic (OC). The recording includes regular perioperative processes (i.a. patient positioning, skin incision, application of wound dressing) and disruptive influences on these processes (e.g. telephone calls, missing or defective instruments, etc.). For this purpose, a software tool was developed (‘s.w.an Suite Arthroscopic toolset’). Based on the data obtained, the processes of the maximum care provider and the special outpatient clinic have been analyzed in terms of performance measures (e.g. Closure-To-Incision-Time), efficiency (e.g. activity duration, OR resource utilization) as well as intra-process disturbances and then compared to one another. Results Despite many similar processes, the results revealed considerable differences in performance indices. The OC required significantly less time than UH for surgical preoperative (UH: 30:47 min, OC: 26:01 min) and postoperative phase (UH: 15:04 min, OC: 9:56 min) as well as changeover time (UH: 32:33 min, OC: 6:02 min). In addition, these phases result in the Closure-to-Incision-Time, which lasted longer at the UH (UH: 80:01 min, OC: 41:12 min). Conclusion The perioperative process organization, team collaboration, and the avoidance of disruptive factors had a considerable influence on the progress of the surgeries. Furthermore, differences in terms of staffing and spatial capacities could be identified. Based on the acquired process data (such as the duration for different surgical steps or the number of interfering events) and the comparison of different arthroscopic departments, approaches for perioperative process optimization to decrease the time of work steps and reduce disruptive influences were identified. |
| first_indexed | 2024-03-09T05:52:03Z |
| format | Article |
| id | doaj.art-38de90a39b6b4c1bb9ba758ce523e50a |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-03-09T05:52:03Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-38de90a39b6b4c1bb9ba758ce523e50a2023-12-03T12:16:36ZengBMCBMC Health Services Research1472-69632023-11-0123111510.1186/s12913-023-10259-3A comparison between a maximum care university hospital and an outpatient clinic – potential for optimization in arthroscopic workflows?Martin Schenk0Juliane Neumann1Nadine Adler2Tilo Trommer3Jan Theopold4Thomas Neumuth5Pierre Hepp6Innovation Center Computer Assisted Surgery (ICCAS), Leipzig UniversityInnovation Center Computer Assisted Surgery (ICCAS), Leipzig UniversityInnovation Center Computer Assisted Surgery (ICCAS), Leipzig UniversitySportklinik.ERFURTDepartment of Orthopaedic, Trauma and Plastic Surgery, Division of Arthroscopic Surgery and Sports Medicine, University of Leipzig Medical CenterInnovation Center Computer Assisted Surgery (ICCAS), Leipzig UniversityDepartment of Orthopaedic, Trauma and Plastic Surgery, Division of Arthroscopic Surgery and Sports Medicine, University of Leipzig Medical CenterAbstract Background Due to the growing economic pressure, there is an increasing interest in the optimization of operational processes within surgical operating rooms (ORs). Surgical departments are frequently dealing with limited resources, complex processes with unexpected events as well as constantly changing conditions. In order to use available resources efficiently, existing workflows and processes have to be analyzed and optimized continuously. Structural and procedural changes without prior data-driven analyses may impair the performance of the OR team and the overall efficiency of the department. The aim of this study is to develop an adaptable software toolset for surgical workflow analysis and perioperative process optimization in arthroscopic surgery. Methods In this study, the perioperative processes of arthroscopic interventions have been recorded and analyzed subsequently. A total of 53 arthroscopic operations were recorded at a maximum care university hospital (UH) and 66 arthroscopic operations were acquired at a special outpatient clinic (OC). The recording includes regular perioperative processes (i.a. patient positioning, skin incision, application of wound dressing) and disruptive influences on these processes (e.g. telephone calls, missing or defective instruments, etc.). For this purpose, a software tool was developed (‘s.w.an Suite Arthroscopic toolset’). Based on the data obtained, the processes of the maximum care provider and the special outpatient clinic have been analyzed in terms of performance measures (e.g. Closure-To-Incision-Time), efficiency (e.g. activity duration, OR resource utilization) as well as intra-process disturbances and then compared to one another. Results Despite many similar processes, the results revealed considerable differences in performance indices. The OC required significantly less time than UH for surgical preoperative (UH: 30:47 min, OC: 26:01 min) and postoperative phase (UH: 15:04 min, OC: 9:56 min) as well as changeover time (UH: 32:33 min, OC: 6:02 min). In addition, these phases result in the Closure-to-Incision-Time, which lasted longer at the UH (UH: 80:01 min, OC: 41:12 min). Conclusion The perioperative process organization, team collaboration, and the avoidance of disruptive factors had a considerable influence on the progress of the surgeries. Furthermore, differences in terms of staffing and spatial capacities could be identified. Based on the acquired process data (such as the duration for different surgical steps or the number of interfering events) and the comparison of different arthroscopic departments, approaches for perioperative process optimization to decrease the time of work steps and reduce disruptive influences were identified.https://doi.org/10.1186/s12913-023-10259-3Surgical workflow analysisArthroscopySurgical process optimizationOperating room management |
| spellingShingle | Martin Schenk Juliane Neumann Nadine Adler Tilo Trommer Jan Theopold Thomas Neumuth Pierre Hepp A comparison between a maximum care university hospital and an outpatient clinic – potential for optimization in arthroscopic workflows? BMC Health Services Research Surgical workflow analysis Arthroscopy Surgical process optimization Operating room management |
| title | A comparison between a maximum care university hospital and an outpatient clinic – potential for optimization in arthroscopic workflows? |
| title_full | A comparison between a maximum care university hospital and an outpatient clinic – potential for optimization in arthroscopic workflows? |
| title_fullStr | A comparison between a maximum care university hospital and an outpatient clinic – potential for optimization in arthroscopic workflows? |
| title_full_unstemmed | A comparison between a maximum care university hospital and an outpatient clinic – potential for optimization in arthroscopic workflows? |
| title_short | A comparison between a maximum care university hospital and an outpatient clinic – potential for optimization in arthroscopic workflows? |
| title_sort | comparison between a maximum care university hospital and an outpatient clinic potential for optimization in arthroscopic workflows |
| topic | Surgical workflow analysis Arthroscopy Surgical process optimization Operating room management |
| url | https://doi.org/10.1186/s12913-023-10259-3 |
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