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Targeting Operating Room Inefficiencies in the Complex Management of Vision-Threatening Diseases in Children
Michael M. Vigoda, MD, MBA;
Steven Gayer, MD, MBA;
Jacqueline Tutiven, MD;
Alice Mueller, MD;
Mary Murtha, RN;
Amy C. Schefler, MD;
Timothy G. Murray, MD, MBA
Arch Ophthalmol. 2008;126(9):1241-1243.
Objective To review the effect of interventions designed to decrease turnover time in infants and children (median age, 2.6 years; range, 1 month to 10 years) who required examinations under anesthesia.
Methods Five efficiency interventions (3 anesthesia providers for 2 rooms, digital remote communication, change in patient scheduling, standardization of case order, and streamlining administration of preoperative medications) were implemented during a 4 -year period from January 2003 to July 2007. Using data from our in-house operating room information system, we analyzed turnover times (time it took 1 patient to leave the operating room and the next to enter).
Results The mean turnover times decreased from 12.1 minutes to 3.8 minutes. The 90th percentile of longest turnover times decreased from 14.5 minutes in 2003 to 5.8 minutes in 2007, despite a progressive increase in the number of cases per day.
Conclusion Caring for children who require extensive examinations under anesthesia can be efficiently achieved in nonpediatric environments.
Author Affiliations: Departments of Anesthesiology, Preoperative Medicine, and Pain Management (Drs Vigoda, Gayer, Tutiven, and Mueller), Surgery (Ms Murtha), and Ophthalmology (Drs Schefler and Murray), Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
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