Organization of surgical services and operating room efficiency in Norwegian hospitals
Notice bibliographique
Résumé
Background Most studies on operating room (OR) efficiency have focused on how local factors within the surgical facilities (micro level), such as turnover time, case duration and non-operative time, affects operating room efficiency. Few studies have analyzed how different strategies for organizing surgical services on the departmental or hospital level (macro level) might affect OR efficiency. Norwegian hospitals have organized their surgical services on the macro level along two different strategies. Most hospitals have separate facilities for out-patient surgery and in-patient surgery, often also geographically separated. Most hospitals also have specialty specific OR (orthopedics, gastroenterology, gynecology etc.), while in other hospitals different subspecialties share the same OR. This study was undertaken to analyze any effect of these different organizational strategies in relation to OR efficiency. Methods Data on organization of surgical services and operation volume for 2009 was gathered from eleven Norwegian university and larger county hospitals with a similar case mix. Total OR efficiency and OR efficiency during ordinary work hours were analyzed separately for out-patient and in-hospital surgery, including emergency operations. Calculation of OR during ordinary hours (8am-3pm) was based on 230 workdays per year, and included emergency operations. Results OR efficiency was 721 operations per OR per year with a range from 525 to 1049 and was not related to the different strategies for organizing these services. Furthermore, no correlation was found between OR efficiency and operation volume or number of OR. OR efficiency during ordinary hours and workdays was 3.6 operations per day for out-patient surgery and 1.8 for in-patient surgery including emergency operations. This was considerably less than standards used in planning surgical facilities in Norwegian hospitals. Conclusion OR efficiency is probably more related to organization of the surgical services on the micro level than to strategies for organizing these services on the macro level. The large variation in operating room efficiency in Norwegian hospitals indicates that many hospitals have a potential for improvement. The discrepancy between actual OR efficiency and standards used for planning of surgical facilities represents a challenge in future hospital planning.
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».