A Model to Evaluate Efficiency in Operating Room Processes.

Efficiency;Operating Room;Scientific Management Theory;Nursing Staff;Economics;Business;Nursing

McLaughlin, Margaret M.Titler, Marita G. ;

University of Michigan

关键词: Efficiency;    Operating Room;    Scientific Management Theory;    Nursing Staff;    Economics;    Business;    Nursing;   

Others  :  https://deepblue.lib.umich.edu/bitstream/handle/2027.42/96155/mmmcl_1.pdf?sequence=1&isAllowed=y

瑞士|英语

来源: The Illinois Digital Environment for Access to Learning and Scholarship

【 摘 要 】

In the operating room, efficiency is related to minutes pared from surgical time.The link between operating room efficiency and the composition of surgical teams has been investigated, yet research on the efficiency of surgical nursing staff members and operating room durations is scant.The purpose of this study was to assess the effects of nursing staff arrangements in surgery, with a view to better planning of staff training and structure to achieve savings in time and money.A conceptual framework based on scientific management theory was used to evaluate efficiency in operating room processes as time within and between surgical cases, and projected that nursing staff arrangements including specialization, standardization, and skill mix in surgical processes were key factors in reducing operating room process time.This retrospective, cross-sectional study examined data from electronic records of general surgery cases conducted in 2008 in a large U.S. teaching hospital.The research questions addressed the amount of variation in operating room process efficiency explained by nursing staff arrangement variables after controlling for environmental, patient health status, and case complexity variables.The explanatory statistical model included four independent variables to reflect operating room nursing staff patterns; four control variables to represent environmental conditions, patient health status, and case complexity; and five dependent variables for separate timeframes.Hierarchical regression analysis confirmed that the degree of nursing staff specialization in general surgery explained a significant portion of the variation in process timeframes spanning the surgical procedure, the duration between surgical cases, and the entirety of time within and between cases.Findings that scientific management principles may represent nursing staff arrangements indicate a need for further research to understand the factors that affect the use of perioperative time.One research avenue is to explore the cost-effectiveness of organizing the operating room nursing staff into specialty service teams; another is to evaluate turnover time as an opportunity cost from the perspective of patients, staff, and payers. Use of this model will improve both day-to-day and longer-term planning to optimize use of resources, in particular, nursing labor inputs, that contribute to an efficient and harmonious health care economy.