<p>Efficiency of Operating Room Processes for Elective Cataract Surgeries Done by Residents in a National University Hospital</p>

Abstract

Purpose Operating room processes must be efficient to boost profitability and minimize cost while retaining surgical care quality. This study aims to assess operating room efficiency for resident-performed elective phacoemulsification surgeries done under local anesthesia by measuring different key performance indicators and comparing this with international benchmark data. Patients and Methods This is a prospective cross-sectional study done in the Department of Ophthalmology of the Philippine General Hospital, the National University Hospital. The operating room milestones were noted and recorded by a single third-party observer in randomly selected operating rooms from April to June 2019. Results Fifty-six phacoemulsification cases in randomly selected rooms fulfilling both inclusion and exclusion criteria were observed. None of the cases started on or before the scheduled 6:30 a.m. cutting time, with an average of 34 (SD 8.53) minutes late. Entry lag was above the median, while exit lag and turnover time were above the 95th percentile compared to benchmarking data. Segment analysis also showed an increased entry lag (35.11% vs 21.5%), significantly higher than benchmarks (t: 10.99, df: 55, p<0.01). Comparison with proposed targets in other studies also showed an increased time for entry lag. Conclusion This study determined that entry lag is the performance indicator that should be addressed to improve efficiency. A multidisciplinary approach and group goal-setting are needed to implement changes in the operating room.

A Randomized Controlled Comparative Study of the Three Over-Bed Techniques for Positioning and Repositioning the Lithotomy Position While Using Stirrups

“… 11 Therefore, enhancing the efficiency of the operating room and accelerating turnaround times are essential for maximizing hospital and social benefits. 12 In this study, we aimed to analyze the utilization of three different over-bed methods for the stirrup lithotomy position, adhering to the principles of effective and feasible process development and meticulous control of each step to enhance efficiency. The objective was to determine the approach that clinical staff preferred.…”

Implementation and Methodology of a Pilot, Localized Video Library of Cataract Surgeries for Residency Training in a Tertiary Philippine Eye Institute

“…Training programs worldwide have different requirements as to the minimum number of cataract surgeries a trainee must perform during their residency period. 8 For a skilled surgeon, cataract operation is normally accomplished in just a few minutes. Therefore, for trainees, reviewing this surgery as a video recording, becomes much more useful, as crucial parts of the surgery can be reviewed in slow-motion or in repeat.…”

Day Surgery Scheduling and Optimization in Large Public Hospitals in China: A Three-Station Job Shop Scheduling Problem

“…Nasiri et al [ 13 ] developed a fuzzy robust stochastic optimization approach to tackle the multiobjective surgery scheduling model. Umali et al [ 14 ] aimed to assess operating room efficiency for resident-performed elective phacoemulsification surgeries performed under local anesthesia by measuring different key performance indicators and comparing this with international benchmark data. Hsu et al [ 15 ] proposed scheduling of surgical operations across multiple operating rooms subject to the limited availability of anesthetists; they abstracted the problem into a theoretical server scheduling problem and formulated an integer programming model to construct a feasible operations schedule that has the minimum makespan.…”