Out by 3:30—A Study in Robotic Bariatric Surgery Efficiency

UrregoHernan,; SanniAliu,; ToroJuan, P; LytleNathaniel,; McCreadyCraig,; Scott, DavisS.; SweeneyJohn, F; LinEdward,; PatelAnkit, D

doi:10.1089/bari.2014.0009

Cited by 4 publications

(2 citation statements)

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“…Consequently, OR turnover times for robotic surgery, can be longer than those of more traditional surgery, and can be highly unreliable, varying between and within a single institution. 4,5 Long, inefficient and unpredictable OR turnovers reduce optimal robot use, impact surgical productivity, affecting the ability to treat patients, with potentially serious financial implications. 6 Given the significant cost of initial investment ($1-2.3 million), annual maintenance costs ($100,000-150,000) and the cost per case in disposable instruments, this may eventually threaten the existence of robotic services as a viable treatment option.…”

Section: Introductionmentioning

confidence: 99%

“…Increasingly, complex surgical automation, such as surgical robots, leads more complex requirements, requiring better skills, teamwork, improved utilization of available resources, and coordination of all critical elements to minimize delay. Consequently, OR turnover times for robotic surgery can be longer than those of more traditional surgery and can be highly unreliable, varying between institutions and within a single institution [4, 5]. Long, inefficient and unpredictable OR turnovers reduce optimal robot use, impact surgical productivity, affecting the ability to treat patients, with potentially serious financial implications [6].…”

Section: Introductionmentioning

confidence: 99%

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Reducing Operating Room Turnover Time for Robotic Surgery Using a Motor Racing Pit Stop Model

et al. 2017

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BACKGROUND Operating room (OR) turnover time, time taken between one patient leaving the OR and the next entering, is an important determinant of OR utilization, a key value metric for hospital administrators. Surgical robots have increased the complexity and number of tasks required during an OR turnover, resulting in highly variable OR turnover times. We sought to streamline the turnover process and decrease robotic OR turnover times and increase efficiency. METHODS Direct observation of 45 pre-intervention robotic OR turnovers was performed. Following a previously successful model for handoffs, we employed concepts from motor racing pit-stops, including briefings, leadership, role definition, task allocation, and task sequencing. Turnover task cards for staff were developed and card assignments were distributed for each turnover. Forty-one cases were observed post intervention. RESULTS Average total OR turnover time was 99.2 minutes (95%CI 88.0-110.3) pre- intervention and 53.2 minutes (95%CI 48.0-58.5) at three months post intervention. Average room ready time from when the patient exited the OR until the surgical technician was ready to receive the next patient was 42.2 minutes (95%CI 36.7-47.7) before the intervention, which reduced to 27.2 minutes at three months (95% CI 24.7-29.7) post intervention (p<0.0001). CONCLUSIONS Role definition, task allocation and sequencing, combined with a visual cue for ease-of-use, create efficient, low resource, sustainable approaches to decreasing robotic OR turnover times. Broader system changes are needed to capitalize on that result. Pit stop and other high-risk industry models may inform approaches to the management of tasks and teams.

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Section: Introductionmentioning

confidence: 99%