Introduction:Regional anesthesia is increasingly used in total joint arthroplasty (TJA). It has shown efficiency benefits as it allows parallel processing of patients in a dedicated block room (BR). However, granular quantification of these benefits to hospital operations is lacking. The goal of this study was to determine the financial effect of establishing a BR using comprehensive operational modeling.Methods:A discrete-event simulation model of daily operating room (OR) patient flow for TJA procedures at a mid-sized hospital was developed. Two scenarios were tested: (1) without and (2) with a BR. Scenarios were compared according to staffing requirements, hours/day, and labor costs. The number of ORs and cases varied from 2 to 6 ORs performing 3 to 5 cases. These results were used as the inputs of a discounted cash flow (CF) model. Discounted CF model outputs were CF, net present value, internal rate of return, and return on investment.Results:Mean time savings of incorporating a BR were 68 min/d (range: 30 to 80 min/d), reducing the OR closing time by 1 hour. Incremental labor costs/day from nurse overtime pay ranged from $2,025 to $10,125 with no BR and $1,595 to $9,045 with a BR, which resulted in an increase in profit/day from $360 to $1,605. The CF/annum was $54,363, the net present value was $213,082, the internal rate of return was 12%, and the return on investment was 43.61%.Discussion:This study demonstrates that under all scenarios, a BR is more profitable than no BR to a hospital performing TJA via a bundled care or private payer remuneration model. A BR was shown to be financially net positive even when considering the necessary financial investment to establish it. In addition, this study demonstrates the potential of combining discrete-event simulation with financial analyses to assess various operational models of care to improve hospital efficiency, such as dedicated trauma rooms and swing rooms.Level of evidence:Level III
Radiographic reporting in adolescent idiopathic scoliosis:Is there a discrepancy comparing radiologists' reports and surgeons' assessments? Karamjot Sidhu,
Introduction: Smart insufflation (SI) techniques relying on valve and membrane-free insufflation are increasing in usage. Although considerable literature exists demonstrating the benefits of SI on procedural ease and patient outcomes, there remains a paucity describing the financial impact of these devices. The purpose of this study was to determine the financial and efficiency impact of these devices on the operating room (OR) and inpatient wards of a hospital. Methods: A discrete event simulation model representing a typical mid-sized North American hospital comparing SI to TI was generated. The National Surgical Quality Improvement (NSQIP) database from 2015 to 2019 was used to populate the model with data supplemented from literature. Outcomes included length of stay (LOS), duration of surgery (DOS), annual procedure volume, profit, return on investment (ROI), and gross profit margin (GPM). Results: The operational parameters demonstrating favorability of SI to TI were DOS and LOS. DOS savings were 10-32 minutes/case while LOS savings were 0-3 days/case. Implementation of an SI led to an increase in annual throughput of 148 cases (12%). LOS decreased by 189 days (19%). This resulted in an increase in net profit of $104,675 per annum. The ROI of SI over TI device was >1000%. Conclusion: Despite the initial financial investment being greater, the implementation of SI offsets these expenses and yields significant financial benefits. Our study demonstrates the financial benefits of SI over TI and illustrates how granular operational and financial analysis of technologies are essential to aid in sound healthcare procurement decision making.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.