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What delays your case start? Exploring operating room inefficiencies

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Abstract

Introduction

Improving operating room (OR) inefficiencies benefits the OR team, hospital, and patients alike but the available literature is limited. Our goal was, using a novel surgical application, to identify any OR incidents that cause delays from the time the patient enters the OR till procedure start (preparatory phase).

Materials and methods

We conducted an IRB approved, prospective, observational study between July 2018 and January 2019. Using a novel surgical application (ExplORer Surgical) three observers recorded disrupting incidents and their duration during the preparatory phase of a variety of general surgery cases. Specifically, the number and duration of anesthesia delays, unnecessary/distracting conversations, missing items, and other delays were recorded from the moment they started until they stopped affecting the normal workflow.

Results

Ninety-six OR cases were assessed. 20 incidents occurred in 18 (19%) of those cases. The average preparatory duration for all the cases was 20.7 ± 8.6 min. Cases without incidents lasted 19.5 ± 7.4 min while cases with incidents lasted 25.9 ± 11.2 min, p = 0.03. The average incident lasted 3.7 min, approximately 18% of the preparatory phase duration.

Conclusion

The use of the ExplORer Surgical app allowed us to accurately record the incidents happening during the preparatory phase of various general surgery operations. Such incidents significantly prolonged the preparatory duration. The identification of those inefficiencies is the first step to targeted interventions that may eventually optimize the efficiency of preoperative preparation.

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Funding

ExplORer Surgical Corp., Inc. (Chicago, IL).

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Authors and Affiliations

  1. Department of Surgery, Indiana University School of Medicine, 545 Barnhill Dr., EH 130, Indianapolis, IN, 46202, USA

    Dimitrios I. Athanasiadis, Sara Monfared, Ambar Banerjee, Annabelle Butler & Dimitrios Stefanidis

  2. Indiana University School of Medicine, Indianapolis, IN, USA

    Jake Whiteside

  3. Indiana University Health North Hospital, Indianapolis, IN, USA

    Ambar Banerjee, Donna Keller, Annabelle Butler & Dimitrios Stefanidis

Authors
  1. Dimitrios I. Athanasiadis
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  2. Sara Monfared
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  3. Jake Whiteside
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  4. Ambar Banerjee
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  5. Donna Keller
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  6. Annabelle Butler
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  7. Dimitrios Stefanidis
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Corresponding author

Correspondence to Dimitrios Stefanidis.

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Disclosures:

We received an institutional funding from the ExplORer Surgical Corp., Inc. (Chicago, IL). Grant # 45-88-296. Dr. Dimitrios I. Athanasiadis received an institutional fund from ExplORer Surgical Corp. Dr. Sara Monfared received an institutional fund from ExplORer Surgical Corp. Dr. Ambar Banerjee received an institutional fund from ExplORer Surgical Corp. Dr. Annabelle Butler received an institutional fund from ExplORer Surgical Corp. Mr. Jake Whiteside received an institutional fund from ExplORer Surgical Corp. Ms. Donna Keller received an institutional fund from ExplORer Surgical Corp. Dr. Dimitrios Stefanidis received an institutional fund from ExplORer Surgical Corp.

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Athanasiadis, D.I., Monfared, S., Whiteside, J. et al. What delays your case start? Exploring operating room inefficiencies. Surg Endosc 35, 2709–2714 (2021). https://doi.org/10.1007/s00464-020-07701-6

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  • DOI: https://doi.org/10.1007/s00464-020-07701-6

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