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Perioperative Anesthesia Lean Implementation IS Associated With Increased Operative Efficiency in Posterior Cervical Surgeries at a High-Volume Spine Center

OBJECTIVE: Lean management strategies aim to increase efficiency by eliminating waste or by improving processes to optimize value. The operating room (OR) is an arena where these strategies can be implemented. We assessed changes in OR efficiency after the application of lean methodology on perioper...

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Autores principales: Ammanuel, Simon G., Chan, Andrew K., DiGiorgio, Anthony M., Alazzeh, Mohanad, Nwachuku, Kelechi, Robinson, Leslie C., Lobo, Errol, Mummaneni, Praveen V.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Spinal Neurosurgery Society 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7338954/
https://www.ncbi.nlm.nih.gov/pubmed/32054140
http://dx.doi.org/10.14245/ns.1938318.159
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author Ammanuel, Simon G.
Chan, Andrew K.
DiGiorgio, Anthony M.
Alazzeh, Mohanad
Nwachuku, Kelechi
Robinson, Leslie C.
Lobo, Errol
Mummaneni, Praveen V.
author_facet Ammanuel, Simon G.
Chan, Andrew K.
DiGiorgio, Anthony M.
Alazzeh, Mohanad
Nwachuku, Kelechi
Robinson, Leslie C.
Lobo, Errol
Mummaneni, Praveen V.
author_sort Ammanuel, Simon G.
collection PubMed
description OBJECTIVE: Lean management strategies aim to increase efficiency by eliminating waste or by improving processes to optimize value. The operating room (OR) is an arena where these strategies can be implemented. We assessed changes in OR efficiency after the application of lean methodology on perioperative anesthesia associated with posterior cervical spine surgeries. METHODS: We utilized pre- and post-lean study design to identify inefficiencies during the perioperative anesthesia process and implemented strategies to improve the process. Patient characteristics were recorded to assess for differences between the 2 groups (group 1, prelean; group 2, post-lean). In the pre-lean period, key steps in the perioperative anesthesia process were identified that were amenable to lean implementation. The time required for each identified key step was recorded by an independent study coordinator. The times for each step were then compared between the groups utilizing univariate analyses. RESULTS: After lean implementation, there was a significant decrease in overall perioperative anesthesia process time (88.4 ± 4.7 minutes vs. 76.2 ± 3.2 minutes, p = 0.04). This was driven by significant decreases in the steps: transport and setup (10.4 ± 0.8 minutes vs. 8.0 ± 0.7 minutes, p = 0.03) and positioning (20.8 ± 2.1 minutes vs. 15.7 ± 1.3 minutes, p = 0.046). Of note, the total time spent in the OR was lower for group 2 (270.1 ± 14.6 minutes vs. 252.8 ± 14.1 minutes) but the result was not statistically significant, even when adjusting for number of operated levels. CONCLUSION: Lean methodology may be successfully applied to posterior cervical spine surgery whereby improvements in the perioperative anesthetic process are associated with significantly increased OR efficiency.
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spelling pubmed-73389542020-07-20 Perioperative Anesthesia Lean Implementation IS Associated With Increased Operative Efficiency in Posterior Cervical Surgeries at a High-Volume Spine Center Ammanuel, Simon G. Chan, Andrew K. DiGiorgio, Anthony M. Alazzeh, Mohanad Nwachuku, Kelechi Robinson, Leslie C. Lobo, Errol Mummaneni, Praveen V. Neurospine Original Article OBJECTIVE: Lean management strategies aim to increase efficiency by eliminating waste or by improving processes to optimize value. The operating room (OR) is an arena where these strategies can be implemented. We assessed changes in OR efficiency after the application of lean methodology on perioperative anesthesia associated with posterior cervical spine surgeries. METHODS: We utilized pre- and post-lean study design to identify inefficiencies during the perioperative anesthesia process and implemented strategies to improve the process. Patient characteristics were recorded to assess for differences between the 2 groups (group 1, prelean; group 2, post-lean). In the pre-lean period, key steps in the perioperative anesthesia process were identified that were amenable to lean implementation. The time required for each identified key step was recorded by an independent study coordinator. The times for each step were then compared between the groups utilizing univariate analyses. RESULTS: After lean implementation, there was a significant decrease in overall perioperative anesthesia process time (88.4 ± 4.7 minutes vs. 76.2 ± 3.2 minutes, p = 0.04). This was driven by significant decreases in the steps: transport and setup (10.4 ± 0.8 minutes vs. 8.0 ± 0.7 minutes, p = 0.03) and positioning (20.8 ± 2.1 minutes vs. 15.7 ± 1.3 minutes, p = 0.046). Of note, the total time spent in the OR was lower for group 2 (270.1 ± 14.6 minutes vs. 252.8 ± 14.1 minutes) but the result was not statistically significant, even when adjusting for number of operated levels. CONCLUSION: Lean methodology may be successfully applied to posterior cervical spine surgery whereby improvements in the perioperative anesthetic process are associated with significantly increased OR efficiency. Korean Spinal Neurosurgery Society 2020-06 2020-06-30 /pmc/articles/PMC7338954/ /pubmed/32054140 http://dx.doi.org/10.14245/ns.1938318.159 Text en Copyright © 2020 by the Korean Spinal Neurosurgery Society This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Ammanuel, Simon G.
Chan, Andrew K.
DiGiorgio, Anthony M.
Alazzeh, Mohanad
Nwachuku, Kelechi
Robinson, Leslie C.
Lobo, Errol
Mummaneni, Praveen V.
Perioperative Anesthesia Lean Implementation IS Associated With Increased Operative Efficiency in Posterior Cervical Surgeries at a High-Volume Spine Center
title Perioperative Anesthesia Lean Implementation IS Associated With Increased Operative Efficiency in Posterior Cervical Surgeries at a High-Volume Spine Center
title_full Perioperative Anesthesia Lean Implementation IS Associated With Increased Operative Efficiency in Posterior Cervical Surgeries at a High-Volume Spine Center
title_fullStr Perioperative Anesthesia Lean Implementation IS Associated With Increased Operative Efficiency in Posterior Cervical Surgeries at a High-Volume Spine Center
title_full_unstemmed Perioperative Anesthesia Lean Implementation IS Associated With Increased Operative Efficiency in Posterior Cervical Surgeries at a High-Volume Spine Center
title_short Perioperative Anesthesia Lean Implementation IS Associated With Increased Operative Efficiency in Posterior Cervical Surgeries at a High-Volume Spine Center
title_sort perioperative anesthesia lean implementation is associated with increased operative efficiency in posterior cervical surgeries at a high-volume spine center
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7338954/
https://www.ncbi.nlm.nih.gov/pubmed/32054140
http://dx.doi.org/10.14245/ns.1938318.159
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