Personnel Handoffs in the OR: What is the Impact on Efficiency?
BACKGROUND AND PURPOSE:
There has been focus on improving OR efficiencies, but there is not a lot of data on intraoperative factors such as personnel handovers
Geynisman-Tan et al. (Female Pelvic Surgery & Reconstructive Surgery, 2018) examined whether personnel handoffs or number of learners in the OR are associated with longer OR times in women having pelvic organ prolapse surgery
Participants: Women undergoing prolapse surgery
Following factors were abstracted
Number of handoffs between anesthesia members
Number of learners
148 women undergoing pelvic organ prolapse surgery were included in the study
mean age was 54; majority white women
Procedures performed were as follows
31% laparoscopic sacrocolpopexies (LASCs)
28% robotic sacrocolpopexies (RASCs)
22% native tissue reconstructions
For minimally invasive sacrocolpopexies (LASC + RASC), mean OR time was 270 ± 65 minutes
Median handovers for sacrocolpopexies
Anesthesia: 2 (interquartile range, 0–4)
Surgical technology: 1 (0–3)
Circulator handoffs: 2 (2–6)
Number of learners in the OR was 4 (interquartile range, 1–7)
Patient comorbidities and American Society of Anesthesiologists class were not associated with longer OR times
Longer OR times were
Positively correlated with increasing numbers of anesthesia, surgical technology, and circulator handoffs
Not correlated with the number of learners
For LASC, every technology handoff was associated with 23 additional minutes of OR time (P = 0.004)
For RASC, every technology handoff was associated with 31 additional minutes of OR time (P = 0.007)
Each circulator handoff was associated with 15 additional minutes (P = 0.05).
Increased number of anesthesia, surgical technology, and circulator handoffs were associated with longer OR times for pelvic organ prolapse surgery
Increased number of learners did not increase time in OR
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Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
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presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
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