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Using operating room turnover time by anesthesia trainee level to assess improving systems-based practice milestones

BACKGROUND: Operating room (OR) metrics are frequently cited when optimizing cost efficacy and quality of care (Weiss et al, Characteristics of operating room procedures in U.S. hospitals, 2011: Statistical brief #170, 2013; Macario A, Anesthesiology 105:237-240, 2006; Childers et al, JAMA Surg 153:...

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Autores principales: Hoffman, Christopher Ryan, Green, Michael Stuart, Liu, Jasmine, Iqbal, Usama, Voralu, Kirtanaa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6280448/
https://www.ncbi.nlm.nih.gov/pubmed/30518428
http://dx.doi.org/10.1186/s12909-018-1409-6
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author Hoffman, Christopher Ryan
Green, Michael Stuart
Liu, Jasmine
Iqbal, Usama
Voralu, Kirtanaa
author_facet Hoffman, Christopher Ryan
Green, Michael Stuart
Liu, Jasmine
Iqbal, Usama
Voralu, Kirtanaa
author_sort Hoffman, Christopher Ryan
collection PubMed
description BACKGROUND: Operating room (OR) metrics are frequently cited when optimizing cost efficacy and quality of care (Weiss et al, Characteristics of operating room procedures in U.S. hospitals, 2011: Statistical brief #170, 2013; Macario A, Anesthesiology 105:237-240, 2006; Childers et al, JAMA Surg 153:e176233, 2018). Little has been reported to evaluate how anesthesia trainees change anesthesia-related efficiencies in the OR. Statistical correlation may demonstrate awareness and implementation of efficient systems-based practice. METHODS: Utilizing computerized OR information systems, specific data regarding anesthesia controlled turnover times were collected (546 data points) over the course of 4 months. The type of surgery performed, patient’s American Society of Anesthesiologists (ASA) physical status and OR turnover times were compared for clinical anesthesia (CA) trainee levels CA1, CA2, CA3 and CRNAs. Standard descriptive statistics were computed. Analysis of variance (ANOVA) was performed to compare the average turnover time. RESULTS: Average OR turnover time was 31 min ranging from 8 to 60 min. There was a significant difference between the OR turnover time of CA-1 (32 min) compared to CA-3 (29 min) (p = 0.017) and CA-1 compared to CRNA (30 min) (p = 0.016). OR turnover time was significantly shorter in CA-3 and CRNA. The analysis showed no differences between OR turnover time of ASA categories. CONCLUSIONS: These findings posit that trainees improve efficiency over time, but that education may for a time come at the expense of productivity. This trend may demonstrate a more profound understanding and mastery of a learner progressing in the graduate medical education system. This interplay plays a key role in clinical and academic shared success.
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spelling pubmed-62804482018-12-10 Using operating room turnover time by anesthesia trainee level to assess improving systems-based practice milestones Hoffman, Christopher Ryan Green, Michael Stuart Liu, Jasmine Iqbal, Usama Voralu, Kirtanaa BMC Med Educ Research Article BACKGROUND: Operating room (OR) metrics are frequently cited when optimizing cost efficacy and quality of care (Weiss et al, Characteristics of operating room procedures in U.S. hospitals, 2011: Statistical brief #170, 2013; Macario A, Anesthesiology 105:237-240, 2006; Childers et al, JAMA Surg 153:e176233, 2018). Little has been reported to evaluate how anesthesia trainees change anesthesia-related efficiencies in the OR. Statistical correlation may demonstrate awareness and implementation of efficient systems-based practice. METHODS: Utilizing computerized OR information systems, specific data regarding anesthesia controlled turnover times were collected (546 data points) over the course of 4 months. The type of surgery performed, patient’s American Society of Anesthesiologists (ASA) physical status and OR turnover times were compared for clinical anesthesia (CA) trainee levels CA1, CA2, CA3 and CRNAs. Standard descriptive statistics were computed. Analysis of variance (ANOVA) was performed to compare the average turnover time. RESULTS: Average OR turnover time was 31 min ranging from 8 to 60 min. There was a significant difference between the OR turnover time of CA-1 (32 min) compared to CA-3 (29 min) (p = 0.017) and CA-1 compared to CRNA (30 min) (p = 0.016). OR turnover time was significantly shorter in CA-3 and CRNA. The analysis showed no differences between OR turnover time of ASA categories. CONCLUSIONS: These findings posit that trainees improve efficiency over time, but that education may for a time come at the expense of productivity. This trend may demonstrate a more profound understanding and mastery of a learner progressing in the graduate medical education system. This interplay plays a key role in clinical and academic shared success. BioMed Central 2018-12-05 /pmc/articles/PMC6280448/ /pubmed/30518428 http://dx.doi.org/10.1186/s12909-018-1409-6 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Hoffman, Christopher Ryan
Green, Michael Stuart
Liu, Jasmine
Iqbal, Usama
Voralu, Kirtanaa
Using operating room turnover time by anesthesia trainee level to assess improving systems-based practice milestones
title Using operating room turnover time by anesthesia trainee level to assess improving systems-based practice milestones
title_full Using operating room turnover time by anesthesia trainee level to assess improving systems-based practice milestones
title_fullStr Using operating room turnover time by anesthesia trainee level to assess improving systems-based practice milestones
title_full_unstemmed Using operating room turnover time by anesthesia trainee level to assess improving systems-based practice milestones
title_short Using operating room turnover time by anesthesia trainee level to assess improving systems-based practice milestones
title_sort using operating room turnover time by anesthesia trainee level to assess improving systems-based practice milestones
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6280448/
https://www.ncbi.nlm.nih.gov/pubmed/30518428
http://dx.doi.org/10.1186/s12909-018-1409-6
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