Operating theatre time, where does it all go? A prospective observational study

Abstract

Objective To assess the accuracy of surgeons and anaesthetists in predicting the time it will take them to complete an operation or procedure and therefore explain some of the difficulties encountered in operating theatre scheduling.Design Single centre, prospective observational study.Setting Plastic, orthopaedic, and general surgical operating theatres at a level 1 trauma centre serving a population of about 370 000.Participants 92 operating theatre staff including surgical consultants, surgical registrars, anaesthetic consultants, and anaesthetic registrars.Intervention Participants were asked how long they thought their procedure would take. These data were compared with actual time data recorded at the end of the case.Primary outcome measure Absolute difference between predicted and actual time.Results General surgeons underestimated the time required for the procedure by 31 minutes (95% confidence interval 7.6 to 54.4), meaning that procedures took, on average, 28.7% longer than predicted. Plastic surgeons underestimated by 5 minutes (−12.4 to 22.4), with procedures taking an average of 4.5% longer than predicted. Orthopaedic surgeons overestimated by 1 minute (−16.4 to 14.0), with procedures taking an average of 1.1% less time than predicted. Anaesthetists underestimated by 35 minutes (21.7 to 48.7), meaning that, on average, procedures took 167.5% longer than they predicted. The four specialty mean time overestimations or underestimations are significantly different from each other (P=0.01). The observed time differences between anaesthetists and both orthopaedic and plastic surgeons are significantly different (P<0.05), but the time difference between anaesthetists and general surgeons is not significantly different. ConclusionThe inability of clinicians to predict the necessary time for a procedure is a significant cause of delay in the operating theatre. This study suggests that anaesthetists are the most inaccurate and highlights the potential differences between specialties in what is considered part of the "anaesthesia time."

RSDNet: Learning to Predict Remaining Surgery Duration from Laparoscopic Videos Without Manual Annotations

“…These factors are difficult, if not impossible, to be incorporated into the preoperative prediction model. For instance, it has been shown by [3] that general surgeons underestimated surgery durations by 31 minutes in average, while anesthesiologists underestimated the durations by 35 minutes (29% and 167% error with respect to predicted durations, respectively). Such underestimation will lead to longer waiting time for patients, e.g., a large variation of waiting time (47±17 mins) over 157 cholecystectomy patients was observed in [4], while it typically requires 25 minutes for patient preparation.…”

A prospective cohort study investigating the use of a surgical planning tool to improve patient fasting times in orthopaedic trauma

“…This degree of accuracy was comparable to medical staff (including orthopaedic surgeon) estimation in the global literature, whereby the best estimates of trauma time were within 30% of actual surgical times 16 . Some studies have shown greater accuracy of orthopaedic surgeons in predicting surgical time but these did not include anaesthetic time, which is vital when predicting timing for orthopaedic trauma lists 17 .…”

“…Planning is essential for efficient implementation of surgical lists. The variability of orthopaedic trauma, however, makes it extremely difficult to predict workload and capacity 1,2 . The surgical priority of patients can change relatively quickly and some complications can render patients acutely unfit for surgery 3 .…”

Planificación Prospectiva Para El Desarrollo Formativo Del Aprendizaje Sobre Metodología De La Investigación Científica en Estudiantes Universitarios Mediante Modalidad Acelerada

“…Uno de los procesos más complejo de la cotidianidad, es la toma de decisiones con base a la planificación (Luo, 2018). La planificación resulta esencial para alcanzar procedimientos eficientes (Wang & Yang, 2014;Travis et al, 2014) y con frecuencia, pensar en el logro de resultados deseados donde podrían incluirse multitudes de situaciones y rutas de orientación al menos, desde la evaluación sobre dos criterios: 1 ro ), valor objetivo de las acciones a realizarse y 2 do ), mostrar capacidades para conseguirse (Fisher, 2018).…”