电子病历时代的手术时间准确性:解决房间里的大象问题。

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-03-01 DOI:10.1097/JHM-D-23-00073
Mohamed Elsaqa, Marawan M El Tayeb, Stephanie Yano, Harry T Papaconstantinou
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引用次数: 0

摘要

目标:准确预测手术室(OR)时间对于有效利用资源、优化人员配置和降低成本至关重要。目前,电子健康记录(EHR)系统通过预测特定外科医生和手术的手术室时间来辅助手术室时间安排。在很多情况下,预测的手术室时间会被外科医生在排班时操纵。我们的目标是解决将电子病历用于手术室排班的问题,以及操作对手术室时间准确性的影响:方法:2022 年 4 月至 8 月期间,我们在三级医疗中心开展了一项试点研究,鼓励多个外科专业的外科医生在排班时不对预测的手术室时间进行操作。对试验前 5 个月内(第 1 组)和试验期间(第 2 组)的手术室时间准确性进行了比较。准确病例的定义是:总长度(轮入到轮出)在±30 分钟以内的病例,或在计划时间≥或主要结论时,总长度在计划时间的±20%以内的病例:研究共包括 8,821 例手术,其中 4,243 例(第 1 组)和 4,578 例(第 2 组),(p 实际应用:利用电子病历系统预测手术室时间并减少外科医生的操作,有助于提高手术室时间安排的准确性和手术室资源的利用率。
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Operative Time Accuracy in the Era of Electronic Health Records: Addressing the Elephant in the Room.

Goal: Accurate prediction of operating room (OR) time is critical for effective utilization of resources, optimal staffing, and reduced costs. Currently, electronic health record (EHR) systems aid OR scheduling by predicting OR time for a specific surgeon and operation. On many occasions, the predicted OR time is subject to manipulation by surgeons during scheduling. We aimed to address the use of the EHR for OR scheduling and the impact of manipulations on OR time accuracy.

Methods: Between April and August 2022, a pilot study was performed in our tertiary center where surgeons in multiple surgical specialties were encouraged toward nonmanipulation for predicted OR time during scheduling. The OR time accuracy within 5 months before trial (Group 1) and within the trial period (Group 2) were compared. Accurate cases were defined as cases with total length (wheels-in to wheels-out) within ±30 min or ±20% of the scheduled duration if the scheduled time is ≥ or <150 min, respectively. The study included single and multiple Current Procedural Terminology code procedures, while procedures involving multiple surgical specialties (combo cases) were excluded.

Principal findings: The study included a total of 8,821 operations, 4,243 (Group 1) and 4,578 (Group 2), (p < .001). The percentage of manipulation dropped from 19.8% (Group 1) to 7.6% (Group 2), (p < .001), while scheduling accuracy rose from 41.7% (Group 1) to 47.9% (Group 2), (p = .0001) with a significant reduction of underscheduling percentage (38.7% vs. 31.7%, p = .0001) and without a significant difference in the percentage of overscheduled cases (15% vs. 17%, p = .22). Inaccurate OR hours were reduced by 18% during the trial period (2,383 hr vs. 1,954 hr).

Practical applications: The utilization of EHR systems for predicting OR time and reducing manipulation by surgeons helps improve OR scheduling accuracy and utilization of OR resources.

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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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