Parallel induction of anesthesia improves operating room (OR) efficiency. To support decision-making as to optimal facilities and optimal use of resources, we compared the cost-efficiency of several workflow models of parallel induction to that of the traditional model, using discrete-event simulation. For each scenario, average number of procedures performed, surgery time, daily over- and underutilized time, and staffing costs per operation were assessed. We also studied whether scheduling short and long procedures in separate rooms would amplify the effects of the parallel processing. All parallel work-flow models demonstrated better cost-efficiency than the traditionally sequenced working pattern. Staffing costs per procedure were 7% lower in the best induction model than in the traditional model. When short procedures were scheduled separately, differences between induction models were small.
The structure of the daily operative management of an operating room needs redefining. There should be more focus on collaboration and communication between the care providers.
A patient tracking system is a promising tool for managing patient flow and improving efficiency in the operating room. Wireless location systems, using infrared or radio frequency transmitters, can automatically timestamp key events, thereby decreasing the need for manual data input. In this study, we measured the accuracy and precision of automatically documented timestamps compared with manual recording. Each patient scheduled for urgent surgery was given an active radio frequency/infrared transmitter. The prototype software tracked the patient throughout the perioperative process, automatically documenting the timestamps. Both automatic and traditional data entry were compared with the reference data. The absolute value of median error was 64% smaller (P < 0.01), and the average quartile deviation of error was 69% smaller in automatic documentation. The average delay between an activity and the documentation was 80 seconds in automatic documentation and 735 seconds in manual documentation. Both the accuracy and the precision were better in automatic documentation and the data were immediately available. Automatic documentation with the Indoor Positioning System can help in managing patient flow and in increasing transparency with faster availability and better accuracy of data.
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