Preventing delays in first-case starts on the neurosurgery service

A resident-led initiative at an academic institution

Seunggu (Jude) Han, John D. Rolston, Corinna C. Zygourakis, Matthew Z. Sun, Michael W. McDermott, Catherine Y. Lau, Manish K. Aghi

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective On-time starts for the first case of the day are critical to maintaining efficiency in operating rooms (ORs). We studied whether a resident-led initiative to ensure on-time site marking and documentation of surgical consent could lead to improved first-case start time. Design and Setting In a resident-led initiative at a large 600-bed academic hospital with 25 ORs, we aimed to complete site marking and surgical consents half an hour before the scheduled start time for all first-case neurosurgical patients. We monitored the occurrence of delayed first starts and the length of delay during our initiative, and compared these cases to neurosurgical cases 3 months before the implementation of the initiative and to first-start nonneurosurgical cases. Results In the year of the initiative, both site marking and surgical consents were completed 30 minutes before the case start in 97% of neurosurgical cases. The average delay across all first-case starts was reduced to 7.17 minutes (N = 1271), compared with 9.67 minutes before the intervention (N = 345). During the study period, non-neurosurgical cases were delayed on average 10.3 minutes (N = 3592). There was a significant difference in latencies between the study period and the period before the initiative (p < 0.001), and also between neurosurgical cases and nonneurosurgical cases (p < 0.001). There was no reduction in delay times seen on the non-neurosurgical services in the study period when compared to the case 3 months before. Considering its effect across 1271 cases, this initiative over 1 year resulted in a total reduction of 52 hours and 57 minutes in delays. Conclusions Through a resident-led quality improvement program, neurosurgical trainees successfully reduced delays in first-case starts on a surgical service. Engaging physician trainees in quality improvement and enhancing OR efficiency can be successfully achieved and can have a significant clinical and financial effect.

Original languageEnglish (US)
Pages (from-to)291-295
Number of pages5
JournalJournal of Surgical Education
Volume73
Issue number2
DOIs
StatePublished - Mar 1 2016
Externally publishedYes

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Neurosurgery
resident
Operating Rooms
Quality Improvement
trainee
efficiency
Documentation
documentation
physician
time
Physicians

Keywords

  • financial incentive
  • first case
  • on-time start
  • operating room efficiency
  • quality improvement
  • resident education

ASJC Scopus subject areas

  • Surgery
  • Education

Cite this

Preventing delays in first-case starts on the neurosurgery service : A resident-led initiative at an academic institution. / Han, Seunggu (Jude); Rolston, John D.; Zygourakis, Corinna C.; Sun, Matthew Z.; McDermott, Michael W.; Lau, Catherine Y.; Aghi, Manish K.

In: Journal of Surgical Education, Vol. 73, No. 2, 01.03.2016, p. 291-295.

Research output: Contribution to journalArticle

Han, Seunggu (Jude) ; Rolston, John D. ; Zygourakis, Corinna C. ; Sun, Matthew Z. ; McDermott, Michael W. ; Lau, Catherine Y. ; Aghi, Manish K. / Preventing delays in first-case starts on the neurosurgery service : A resident-led initiative at an academic institution. In: Journal of Surgical Education. 2016 ; Vol. 73, No. 2. pp. 291-295.
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abstract = "Objective On-time starts for the first case of the day are critical to maintaining efficiency in operating rooms (ORs). We studied whether a resident-led initiative to ensure on-time site marking and documentation of surgical consent could lead to improved first-case start time. Design and Setting In a resident-led initiative at a large 600-bed academic hospital with 25 ORs, we aimed to complete site marking and surgical consents half an hour before the scheduled start time for all first-case neurosurgical patients. We monitored the occurrence of delayed first starts and the length of delay during our initiative, and compared these cases to neurosurgical cases 3 months before the implementation of the initiative and to first-start nonneurosurgical cases. Results In the year of the initiative, both site marking and surgical consents were completed 30 minutes before the case start in 97{\%} of neurosurgical cases. The average delay across all first-case starts was reduced to 7.17 minutes (N = 1271), compared with 9.67 minutes before the intervention (N = 345). During the study period, non-neurosurgical cases were delayed on average 10.3 minutes (N = 3592). There was a significant difference in latencies between the study period and the period before the initiative (p < 0.001), and also between neurosurgical cases and nonneurosurgical cases (p < 0.001). There was no reduction in delay times seen on the non-neurosurgical services in the study period when compared to the case 3 months before. Considering its effect across 1271 cases, this initiative over 1 year resulted in a total reduction of 52 hours and 57 minutes in delays. Conclusions Through a resident-led quality improvement program, neurosurgical trainees successfully reduced delays in first-case starts on a surgical service. Engaging physician trainees in quality improvement and enhancing OR efficiency can be successfully achieved and can have a significant clinical and financial effect.",
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AB - Objective On-time starts for the first case of the day are critical to maintaining efficiency in operating rooms (ORs). We studied whether a resident-led initiative to ensure on-time site marking and documentation of surgical consent could lead to improved first-case start time. Design and Setting In a resident-led initiative at a large 600-bed academic hospital with 25 ORs, we aimed to complete site marking and surgical consents half an hour before the scheduled start time for all first-case neurosurgical patients. We monitored the occurrence of delayed first starts and the length of delay during our initiative, and compared these cases to neurosurgical cases 3 months before the implementation of the initiative and to first-start nonneurosurgical cases. Results In the year of the initiative, both site marking and surgical consents were completed 30 minutes before the case start in 97% of neurosurgical cases. The average delay across all first-case starts was reduced to 7.17 minutes (N = 1271), compared with 9.67 minutes before the intervention (N = 345). During the study period, non-neurosurgical cases were delayed on average 10.3 minutes (N = 3592). There was a significant difference in latencies between the study period and the period before the initiative (p < 0.001), and also between neurosurgical cases and nonneurosurgical cases (p < 0.001). There was no reduction in delay times seen on the non-neurosurgical services in the study period when compared to the case 3 months before. Considering its effect across 1271 cases, this initiative over 1 year resulted in a total reduction of 52 hours and 57 minutes in delays. Conclusions Through a resident-led quality improvement program, neurosurgical trainees successfully reduced delays in first-case starts on a surgical service. Engaging physician trainees in quality improvement and enhancing OR efficiency can be successfully achieved and can have a significant clinical and financial effect.

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