A comparison of inhalational inductions for children in the operating room vs the induction room

Varughese, Anna M.; Hagerman, Nancy S.; Patiño, Mario; Wittkugel, Eric P.; Schnell, Beverly; Salisbury, Shelia; Kurth, Dean

doi:10.1111/j.1460-9592.2011.03755.x

Cited by 11 publications

(9 citation statements)

References 29 publications

(33 reference statements)

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“…Case starts are the start time of the surgical procedures. Case time ( CT ) is the duration between previous patient out of OR and current patient out of OR 26 . Procedure time ( PT ) is defined as the time interval between the patient entering the OR and patient leaving the OR.…”

Section: Methodsmentioning

confidence: 99%

“…In literature survey, it is seen that there are many different performance indicators related with performance of operating rooms. The most common indicators used in literature and practice is classified into time, cost, rate, and output based on and listed as follows: Time‐based indicators Average durations of processes 11,15,32 Patient in room to surgery start time or surgery finish to patient out of room time 32 Overtime durations 1 Start time tardiness 11 Cost‐based indicators Excess staffing costs and contribution margin per OR hour 11 Fixed and operational costs 15 Rate‐based indicators Productivity, patient or staff satisfactions, percentage of prolonged turnovers 11,13 OR efficiency 26 or resource utilizations, 13,22,33 ratio of time spent by patients in OR to total available time 34 Percentage on‐time starts 13 Cancelation rate 15,32 Output‐based indicators Number of cases performed 11,13,15,35 Number of complications 15 …”

Section: Methodsmentioning

confidence: 99%

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A survey on performance management of operating rooms and a new KPI proposal

Sönmez

Pintelon

2020

Quality & Reliability Eng

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Performance management of operating rooms is of great importance in hospital management. From the patients' point of view, operating room capacity management ensures available capacity when needed and thus ensuring short (er) waiting time. From the hospital point of view, efficiently and effectively managing these expensive resources is a major concern. Because there are too many performance indicators with a lack of standardization on definitions and there is no one‐size‐fit‐all metric that can assess the overall performance, how to measure is still a challenging question. This paper starts with describing the operating room's characteristics and presents a systematic literature survey exploring different sources for information on operating room performance management. The literature is screened for lists of performance indicators currently used by managers. Aside from the nature of indicators, the way these indicators are used is also investigated. The literature ends with the suggestion of a new key performance indicator (overall operating room effectiveness [OORE]) that is intended to be used in measuring the overall performance of operating rooms from a lean thinking perspective. To increase the ability of finding root causes of low performance, a delay categorization framework is also proposed. Implementation of the KPI is illustrated using a real‐world data. In the conclusion, all the elements studied are brought together, and recommendations for research and practice are formulated.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

A survey on performance management of operating rooms and a new KPI proposal

Sönmez

Pintelon

2020

Quality & Reliability Eng

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“…Several studies have found that communication breakdown among teams of providers is prevalent in health care and commonly contributes to avoidable errors. [3][4][5][6][7][11][12][13][14][15] A surgical procedure that lends itself to the systematic evaluation of is a commonly performed short procedure with potential for adverse airway events. The present study aimed to investigate opportunities for improved patient safety and OR efficiency during pediatric MLB and to evaluate the effectiveness of a QI initiative.…”

Section: Discussionmentioning

confidence: 99%

“…Case timing was evaluated using intervals and definitions described by Varughese et al 11 Since some cases involved a combination of MLB and other procedures, in the current study, the time from procedure start to procedure end (T2) was calculated both for the entire operative time and for just the MLB portion of each operation. The QI team elected to include combination cases because MLB-only procedures are less frequently scheduled than MLB combination procedures.…”

Section: -10mentioning

confidence: 99%

Improving Operative Flow During Pediatric Airway Evaluation

Prager

Ruiz

Mooney

et al. 2015

JAMA Otolaryngol Head Neck Surg

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IMPORTANCEMicrolaryngoscopy and bronchoscopy procedures (MLBs) are short-duration, high-acuity procedures that carry risk. Poor case flow and communication exacerbate such potential risk. Efficient operative flow is critical for patient safety and resource expenditure.OBJECTIVES To identify areas for improvement and evaluate the effectiveness of a multidisciplinary quality-improvement (QI) initiative. DESIGN, SETTING, AND PARTICIPANTSA QI project using the "Plan-Do-Study-Act" (PDSA) cycle was implemented to assess MLBs performed on pediatric patients in a tertiary academic children's hospital. Forty MLBs were audited using a QI evaluation tool containing 144 fields. Each MLB was evaluated for flow, communication, and timing. Opportunities for improvement were identified. Subsequently, QI interventions were implemented in an iterative cycle, and 66 MLBs were audited after the intervention.INTERVENTIONS Specific QI interventions addressed issues of personnel frequently exiting the operating room (OR) and poor preoperative preparation, identified during QI audit as areas for improvement. Interventions included (1) conducting "huddles" between surgeon and OR staff to discuss needed equipment; (2) implementing improvements to surgeon case ordering and preference cards review; (3) posting an OR door sign to limit traffic during airway procedures; and (4) discouraging personnel breaks during airway procedures. MAIN OUTCOMES AND MEASURESOperating room exiting behavior of OR personnel, preoperative preparation, and case timing were assessed and compared before and after the QI intervention.RESULTS Personnel exiting the OR during the MLB was identified as a preintervention issue, with the surgical technologist, circulator, or surgeon exiting the room in 55% of cases (n = 22). The surgical technologist and circulator left the room to retrieve equipment in 40% of cases (n = 16), which indicated the need for increased preoperative preparation to improve case timing and operative flow. The QI interventions implemented to address these concerns included education regarding break timing, improvements in communication, and improvements in ordering and preparation of equipment. After the QI intervention, the surgical technologist exiting rate decreased from 20% (n = 8) to 8% (n = 5), and the circulator exiting rate decreased from 38% (n = 15) to 27% (n = 17). In addition, the rate of surgeon exiting decreased significantly (from 25% [n = 10 of 40] to 9% [n = 6 of 66]) (P = .03). The surgical technologist and circulating nurse remaining in the room were significantly associated with decreased operating time (1.84-minute decrease for surgical technologist [P = .04] and 1.95-minute decrease for circulating nurse [P = .001]).CONCLUSIONS AND RELEVANCE Gains were made in personnel exiting behavior and case timing after implementation of the QI interventions, potentially leading to decreased risk. This process is easily reproduced and is widely accepted by stakeholders.

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“…All patient documents accompany the patient equipment. There are no significant differences in distress caused between anesthetising in the anaesthetic room or the operating theatre (Varughese et al 2012), provided appropriate familiarisation with the anaesthetic machine, breathing circuit, mask and monitoring equipment had occurred. Familiarisation can be performed in an interactive play format, activating the flashing lights, funny sounds and blowing up the reservoir 'balloon' or getting used to the anaesthetic circuit which can blow wind and fresh air like a hairdryer by activating the oxygen flush.…”

Section: Introductionmentioning

confidence: 99%

The Soothing Patients' Anxiety ‘Spa’ Experience

Harris

2015

Journal of Perioperative Practice

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This paper examines a blended approach to minimising patient anxiety levels prior to general anaesthesia for adult and paediatric patients with a learning disability by introducing reasonable adjustments and reasonable distractions. A therapeutic environment is created that promotes wellbeing; restrictive interventions are used only when there is potential for harm to the patient or others. The result can be excellent holistic individual patient care, the patient receiving 'added value' and a positive experience.

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A comparison of inhalational inductions for children in the operating room vs the induction room

Cited by 11 publications

References 29 publications

A survey on performance management of operating rooms and a new KPI proposal

A survey on performance management of operating rooms and a new KPI proposal

Improving Operative Flow During Pediatric Airway Evaluation

The Soothing Patients' Anxiety ‘Spa’ Experience

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