An assessment of the quality indicators of operative and non-operative times in a public university hospital

Abstract

Objective To assess the operative time indicators in a public university hospital.Methods A descriptive cross-sectional study was conducted using data from operating room database. The sample was obtained from January 2011 to January 2012. The operations performed in sequence in the same operating room, between 7:00 am and 5:00 pm, elective or emergency, were included. The procedures with incomplete data in the system were excluded, as well as the operations performed after 5:00 pm or on weekends or holidays.Results We measured the operative and non-operative time of 8,420 operations. The operative time (mean and standard deviation) of anesthesias and operations were 177.6±110 and 129.8±97.1 minutes, respectively. The total time of the patient in operative room (mean and standard deviation) was 196.8±113.2. The non-operative time, e.g., between the arrival of the patient and the onset of anesthesia was 14.3±17.3 minutes. The time to set the next patient in operating room was 119.8±79.6 minutes. Our total non-operative time was 155 minutes.Conclusion Delays frequently occurred in our operating room and had a major effect on patient flow and resource utilization. The non-operative time was longer than the operative time. It is possible to increase the operating room capacity by management and training of the professionals involved. The indicators provided a tool to improve operating room efficiency.

Assessment of operative times of multiple surgical specialties in a public university hospital

“… 5 , 13 , 14 The duration of a procedure depends on patient individuality, particular characteristics of the disease, and the surgeon’s skill - the mean duration of the procedure does contemplate such variations. 3 Mean operative time was similar to the reference standard performance found in the literature – approximately 120 minutes. 11 …”

“…Considering the significant number of operations performed worldwide, gathering appropriate information is essential to understand operating room characteristics, identify possible issues, and make it more efficient. 3 The collection of data in our sector was performed by the nursing staff through a hand filled form. About 30% of the obtained information was incomplete, especially due to the absence of data in certain fields of the form, or illegible data.…”

“… 11 , 13 Information on operating room management and on the number of operations performed in Brazil are limited. 3 We analysed over 8,000 procedures with complete information, which allowed us to obtain the mean duration of specific procedures. Despite unpredictable events and complications that may occur during an operation, management and planning on operating room time must be done based on that information.…”

“…2 The operating room is one of the most complex structures of the hospital system, and generally more than 60% of admitted patients need some surgical intervention. 3 - 5 For the operating room management, the basis is the surgical suite, and evaluation can be divided into duration of anesthesia, operative time, operating room time, and operating room preparation time. Anesthesia duration is divided into four moments: anesthetic induction, maintenance, awakening and recovery.…”

Medição da qualidade em centro cirúrgico: quais indicadores utilizamos?

“…Em uma revisão de literatura, os autores citaram como importantes os indicadores voltados ao monitoramento de lesões, quedas, queimaduras por bisturi elétrico, lesões por posicionamento e infecção do sítio cirúrgico 3 . Outra publicação sugeriu indicadores como tempo operatório, primeira cirurgia do dia e tempo não operatório, relacionados à gestão do tempo das cirurgias, à disponibilidade de materiais e ao preparo de SO 10 . No entanto chamam a atenção esses mesmos indicadores, que deveriam ser monitorados em sua completude, por exemplo, o de infecção relacionada à assistência à saúde.…”