scholarly journals Implementing, Connecting, and Evaluating a Standard-Based Integrated Operating Room within a German University Hospital

ACI Open ◽  
2018 ◽  
Vol 02 (01) ◽  
pp. e10-e20
Author(s):  
Raluca Dees ◽  
Angela Merzweiler ◽  
Gerd Schneider ◽  
Martin Kasparick ◽  
Lars Mündermann ◽  
...  
Keyword(s):  
Iterative Method ◽  
Operating Room ◽  
Medical Devices ◽  
Clinical Relevance ◽  
Additional Data ◽  
Operating Rooms ◽  
University Hospital ◽  
Human Machine Interfaces ◽  
It Systems ◽  
Integrated Operating Room

Background Digital operating rooms (ORs), when optimally designed and integrated, can reduce the complexity of the surgery suite. However, many integrated ORs are effectively isolated from other IT systems in the hospital because there is little or no connectivity with them. Within the German flagship project OR.NET, concepts and components were developed for a standard-based connection of the OR with hospital IT systems. Objectives The aim of this work was to implement and evaluate OR.NET concepts and components within the existing IT landscape of a German university hospital. This article describes and evaluates the implemented architecture and processes for connecting a demo OR to existing hospital IT systems at Heidelberg University Hospital. Methods For the design, establishment, and evaluation of standard-based connections of the demo OR with hospital IT systems, the iterative method “Design and Creation” with four iterations was applied. Results A generic and a concrete architecture for several standard-based connection concepts of the demo OR were developed. Furthermore, the concrete architecture was implemented and evaluated for its technical and clinical relevance. The main benefits of the project were the establishment of basic requisites for improving the efficiency within the OR, easier operation of medical devices as a result of harmonized human–machine interfaces, and providing additional data for improving healthcare. Conclusion OR.NET concepts for a standard-based connection of the OR with hospital IT systems have proven to be promising. They can serve as a reference for further integration scenarios in other hospitals.

Connecting the clinical IT infrastructure to a service-oriented architecture of medical devices

2018 ◽  
Vol 63 (1) ◽  
pp. 57-68 ◽  
Author(s):  
Björn Andersen ◽  
Martin Kasparick ◽  
Hannes Ulrich ◽  
Stefan Franke ◽  
Jan Schlamelcher ◽  
...  
Keyword(s):  
Medical Devices ◽  
Service Oriented Architecture ◽  
Point Of Care ◽  
Qualitative Evaluation ◽  
It Infrastructure ◽  
It Systems ◽  
Service Oriented ◽  
Clinical Environments ◽  
Integrated Operating Room ◽  
Ieee 11073

AbstractThe new medical device communication protocol known as IEEE 11073 SDC is well-suited for the integration of (surgical) point-of-care devices, so are the established Health Level Seven (HL7) V2 and Digital Imaging and Communications in Medicine (DICOM) standards for the communication of systems in the clinical IT infrastructure (CITI). An integrated operating room (OR) and other integrated clinical environments, however, need interoperability between both domains to fully unfold their potential for improving the quality of care as well as clinical workflows. This work thus presents concepts for the propagation of clinical and administrative data to medical devices, physiologic measurements and device parameters to clinical IT systems, as well as image and multimedia content in both directions. Prototypical implementations of the derived components have proven to integrate well with systems of networked medical devices and with the CITI, effectively connecting these heterogeneous domains. Our qualitative evaluation indicates that the interoperability concepts are suitable to be integrated into clinical workflows and are expected to benefit patients and clinicians alike. The upcoming HL7 Fast Healthcare Interoperability Resources (FHIR) communication standard will likely change the domain of clinical IT significantly. A straightforward mapping to its resource model thus ensures the tenability of these concepts despite a foreseeable change in demand and requirements.

Operating Room Management In Klaipėda University Hospital: Prospective Analysis In 2009

2016 ◽  
Vol 26 (5) ◽  
pp. 114-119
Author(s):  
Renata Paškevičiūtė ◽  
Geda Klimavičiūtė
Keyword(s):  
Operating Room ◽  
Surgical Procedures ◽  
Surgical Procedure ◽  
Operating Rooms ◽  
Turnover Time ◽  
University Hospital ◽  
Time Variability ◽  
Procedure Time ◽  
High Turnover ◽  
Scheduled Time

Summary Background: Klaipeda University Hospital performs about 30000 surgical procedures every year. The operating room (OR) is a major production unit in hospital. The OR is very expensive to construct and to operate. The goal might be thought to be full utilization of all operating rooms during all hours that they are staffed and available for scheduling. Management is the ability to apply a diverse body of knowledge to accomplish planning, organizing, staffing, leading, and controling a work group. Methods: We decided accidentally to choose and to analyze OR utilization. We had analyzed central operating department consisting of 9 ORs with regularly scheduled time 8:00 AM to 4:00 PM (8 h), full staffed in 2009 four months period (78 workdays). Four months (78 workdays) of data were collected from the 9 operating rooms surveys. Holidays and weekends were excluded.The data was analyzed using “ Statistica” version 7.Results: There were performed 1982 surgical procedures (elective – 1807 (91,2%), urgent – 99 (5%), cancelled – 76 (3,8%)) during investigated period regularly scheduled time (8 h). Actually utilized OR time of all 9 ORs was 4648 h (82,76%), it was planned to work 5616 h. Our OR utilization was 82,76% during investigated period. Total under – utilized time was 968 h (17,36%). Surgeon estimated surgical procedure time was longer than actual surgical procedure time, variability of case duration between surgical teams was high. Turnover time mean duration was 28 min. Conclusions: Our study demonstrates that our central operating department have been worked efficiently (OR utilization was 82,76%, case cancellation rate was 3,8%, mean turnover time was 28 min, prolonged turnovers were less than 10%) in 2009 (four month period).

scholarly journals Use of the surgical safety checklist in the operating room: Operating room nurses’ perspectives

2019 ◽  
Vol 35 (3) ◽  
Author(s):  
Oznur Gurlek Kisacik ◽  
Yeliz Cigerci
Keyword(s):  
Operating Room ◽  
Operating Rooms ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Cross Sectional ◽  
Team Collaboration ◽  
Surgical Safety Checklist ◽  
Surgical Safety ◽  
Creative Commons ◽  
Operating Room Nurses

Objective: To determine the opinions of operating room nurses towards the Surgical Safety ChecklistTR (SSCTR) and to determine applications for using SSCTR in operating rooms. Methods: This descriptive and cross-sectional study was conducted with 102 nurses working in the operating rooms of a state hospital and a university hospital in the Afyonkarahisar province. Descriptive statistics method were used for data analysis. Results: It was found that all operating room nurses knew the SSCTR and that they had a positive opinion regarding the necessity of the SSCTR. However, most of the participants stated that the SSCTR was not applied effectively in the operating room. Conclusion: The results obtained from the study show that changes focusing on the development of a culture of patient safety (PS) and team collaboration in operating rooms must be made in order to apply SSCTR consistently and properly. doi: https://doi.org/10.12669/pjms.35.3.29 How to cite this:Kisacik OG, Cigerci Y. Use of the surgical safety checklist in the operating room: Operating room nurses’ perspectives. Pak J Med Sci. 2019;35(3):---------. doi: https://doi.org/10.12669/pjms.35.3.29 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Simulation-based evaluation of operating room management policies

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jan Schoenfelder ◽  
Sebastian Kohl ◽  
Manuel Glaser ◽  
Sebastian McRae ◽  
Jens O. Brunner ◽  
...  
Keyword(s):  
Operating Room ◽  
Hospital Admissions ◽  
Operating Rooms ◽  
University Hospital ◽  
Operating Room Management ◽  
Operating Theater ◽  
Data Set ◽  
Trade Offs ◽  
Simulation Based ◽  
Management Policies

Abstract Background Since operating rooms are a major bottleneck resource and an important revenue driver in hospitals, it is important to use these resources efficiently. Studies estimate that between 60 and 70% of hospital admissions are due to surgeries. Furthermore, staffing cannot be changed daily to respond to changing demands. The resulting high complexity in operating room management necessitates perpetual process evaluation and the use of decision support tools. In this study, we evaluate several management policies and their consequences for the operating theater of the University Hospital Augsburg. Methods Based on a data set with 12,946 surgeries, we evaluate management policies such as parallel induction of anesthesia with varying levels of staff support, the use of a dedicated emergency room, extending operating room hours reserved as buffer capacity, and different elective patient sequencing policies. We develop a detailed simulation model that serves to capture the process flow in the entire operating theater: scheduling surgeries from a dynamically managed waiting list, handling various types of schedule disruptions, rescheduling and prioritizing postponed and deferred surgeries, and reallocating operating room capacity. The system performance is measured by indicators such as patient waiting time, idle time, staff overtime, and the number of deferred surgeries. Results We identify significant trade-offs between expected waiting times for different patient urgency categories when operating rooms are opened longer to serve as end-of-day buffers. The introduction of parallel induction of anesthesia allows for additional patients to be scheduled and operated on during regular hours. However, this comes with a higher number of expected deferrals, which can be partially mitigated by employing additional anesthesia teams. Changes to the sequencing of elective patients according to their expected surgery duration cause expectable outcomes for a multitude of performance indicators. Conclusions Our simulation-based approach allows operating theater managers to test a multitude of potential changes in operating room management without disrupting the ongoing workflow. The close collaboration between management and researchers in the design of the simulation framework and the data analysis has yielded immediate benefits for the scheduling policies and data collection efforts at our practice partner.

scholarly journals Design Opportunities to Reduce Waste in Operating Rooms

2021 ◽  
Vol 13 (4) ◽  
pp. 2207
Author(s):  
Charlotte Harding ◽  
Joren Van Loon ◽  
Ingrid Moons ◽  
Gunter De Win ◽  
Els Du Bois
Keyword(s):  
Operating Room ◽  
Circular Economy ◽  
Operating Rooms ◽  
Medical Waste ◽  
Waste Reduction ◽  
Infrastructure Management ◽  
Expert Interviews ◽  
Hospital Waste ◽  
Observation Results ◽  
Taking Care

While taking care of the population’s health, hospitals generate mountains of waste, which in turn causes a hazard to the environment of the population. The operating room is responsible for a disproportionately big amount of hospital waste. This research aims to investigate waste creation in the operating room in order to identify design opportunities to support waste reduction according to the circular economy. Eight observations and five expert interviews were conducted in a large sized hospital. The hospital’s waste infrastructure, management, and sterilization department were mapped out. Findings are that washable towels and operation instruments are reused; paper, cardboard, and specific fabric are being recycled; and (non-)hazardous medical waste is being incinerated. Observation results and literature findings are largely comparable, stating that covering sheets of the operation bed, sterile clothing, sterile packaging, and department-specific products are as well the most used and discarded. The research also identified two waste hotspots: the logistical packaging (tertiary, secondary, and primary) of products and incorrect sorting between hazardous and non-hazardous medical waste. Design opportunities include optimization of recycling and increased use of reusables. Reuse is the preferred method, more specifically by exploring the possibilities of reuse of textiles, consumables, and packaging.

scholarly journals An assessment of the quality indicators of operative and non-operative times in a public university hospital

2015 ◽  
Vol 13 (4) ◽  
pp. 594-599 ◽  
Author(s):  
Altair da Silva Costa Jr ◽  
Luiz Eduardo Villaça Leão ◽  
Maykon Anderson Pires de Novais ◽  
Paola Zucchi
Keyword(s):  
Standard Deviation ◽  
Operating Room ◽  
Operative Time ◽  
Patient Flow ◽  
Cross Sectional Study ◽  
Public University ◽  
Major Effect ◽  
University Hospital ◽  
Cross Sectional ◽  
Using Data

ABSTRACT Objective To assess the operative time indicators in a public university hospital. Methods A descriptive cross-sectional study was conducted using data from operating room database. The sample was obtained from January 2011 to January 2012. The operations performed in sequence in the same operating room, between 7:00 am and 5:00 pm, elective or emergency, were included. The procedures with incomplete data in the system were excluded, as well as the operations performed after 5:00 pm or on weekends or holidays. Results We measured the operative and non-operative time of 8,420 operations. The operative time (mean and standard deviation) of anesthesias and operations were 177.6±110 and 129.8±97.1 minutes, respectively. The total time of the patient in operative room (mean and standard deviation) was 196.8±113.2. The non-operative time, e.g., between the arrival of the patient and the onset of anesthesia was 14.3±17.3 minutes. The time to set the next patient in operating room was 119.8±79.6 minutes. Our total non-operative time was 155 minutes. Conclusion Delays frequently occurred in our operating room and had a major effect on patient flow and resource utilization. The non-operative time was longer than the operative time. It is possible to increase the operating room capacity by management and training of the professionals involved. The indicators provided a tool to improve operating room efficiency.

scholarly journals Assessing Risks Awareness in Operating Rooms among Post-Graduate Students: A Pilot Study

2021 ◽  
Vol 13 (7) ◽  
pp. 3860
Author(s):  
Anna Rita Corvino ◽  
Pasquale Manco ◽  
Elpidio Maria Garzillo ◽  
Maria Grazia Lourdes Monaco ◽  
Alessandro Greco ◽  
...  
Keyword(s):  
Risk Perception ◽  
Pilot Study ◽  
Graduate Students ◽  
Ionizing Radiation ◽  
Operating Room ◽  
Training Programs ◽  
Occupational Risk ◽  
University Hospital ◽  
Cross Sectional Survey ◽  
Post Graduate

Background: In this study, we promote a global approach to occupational risk perception in order to improve occupational health and safety training programs. The study investigates the occupational risk perception of operating room healthcare workers using an Analytic Hierarchy Process approach. Methods: A pilot study was carried out through a cross-sectional survey in a university hospital in Southern Italy. An ad hoc questionnaire was administered to enrolled medical post-graduate students working in the operating room. Results: Fifty medical specialists from seven fields (anaesthetists, digestive system surgeons, general surgeons, maxillofacial surgeons, thoracic surgeons, urologists, and gynaecologists) were questioned about perceived occupational risk by themselves. Biological, ionizing radiation, and chemical risks were the most commonly perceived in order of priority (w = 0.300, 0.219, 0.210). Concerning the biological risk, gynaecologists unexpected perceived this risk as less critical (w = 0.2820) than anaesthesiologists (w = 0.3354), which have the lowest perception of the risk of ionizing radiation (w = 0.1657). Conclusions: Prioritization methods could improve risk perception in healthcare settings and help detect training needs and perform sustainable training programs.

scholarly journals Effects of certain disinfectants and antibiotics on biofilm formation by Staphylococcus aureus isolated from medical devices at the University Hospital Center of Sidi Bel Abbes, Algeria

2020 ◽  
Vol 21 (4) ◽  
pp. 304-310
Author(s):  
I. Kara Terki ◽  
H. Hassaine ◽  
A. Kara Terki ◽  
B. Nadira ◽  
N. Kara Terki ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Medical Devices ◽  
Biofilm Formation ◽  
University Hospital ◽  
Centre Hospitalier ◽  
Treatment And Prevention ◽  
Centre Hospitalier Universitaire ◽  
Dispositif Médical ◽  
The University ◽  
Hospital Center

Background: Staphylococcus aureus is one of the species of bacteria most frequently isolated from medical devices. The ability to produce biofilm is an important step in the pathogenesis of these staphylococci infection, and biofilm formation is strongly dependent on environmental conditions as well as antibiotics and disinfectants used in the treatment and prevention of infections.Methodology: In this study, 28 S. aureus isolated from medical devices at the University Hospital Center of Sidi Bel Abbes in Northwestern Algeria were tested for biofilm formation by culture on Red Congo Agar (RCA). The tube method (TM) and tissue culture plate (TCP) techniques were also used to investigate the effect of penicillin, ethanol and betadine on pre-formed biofilm.Results: Nineteen S. aureus isolates produced biofilm on the RCA and 7 produced biofilms by the tube method, 2 of which were high producer. In addition, 9 S. aureus isolates produced biofilm on polystyrene micro-plates, and in the presence of penicillin and ethanol, this number increased to 19 and 11 biofilm producing S. aureus isolates respectively. On the other hand, no biofilm was formed in the presence of betadine.Conclusion: It is important to test for biofilm formation following an imposed external constraint such as disinfectants and antibiotics in order to develop new strategies to combat bacterial biofilms but also to better control their formation. Keywords : Staphylococcus aureus, biofilm, medical device, disinfectant, antibiotic French Title: Effets de certains désinfectants et antibiotiques sur la formation de biofilms par Staphylococcus aureus isolé à partir de dispositifs médicaux au Centre Hospitalier Universitaire de Sidi Bel Abbès, Algérie Contexte: Staphylococcus aureus est l'une des espèces de bactéries les plus fréquemment isolées des dispositifs médicaux. La capacité de produire du biofilm est une étape importante dans la pathogenèse de ces infections à staphylocoques, et la formation de biofilm dépend fortement des conditions environnementales ainsi que des antibiotiques et des désinfectants utilisés dans le traitement et la prévention des infections. Méthodologie: Dans cette étude, 28 S. aureus isolés à partir de dispositifs médicaux au Centre hospitalier universitaire de Sidi Bel Abbès dans le nord-ouest de l'Algérie ont été testés pour la formation de biofilm par culture sur gélose rouge du Congo (RCA). La méthode des tubes (TM) et les techniques de plaques de culture tissulaire (TCP) ont également été utilisées pour étudier l'effet de la pénicilline, de l'éthanol et de la bétadine sur le biofilm préformé. Résultats: Dix-neuf isolats de S. aureus ont produit un biofilm sur le RCA et 7 ont produit des biofilms par la méthode des tubes, dont 2 étaient très productifs. De plus, 9 isolats de S. aureus ont produit du biofilm sur des microplaques en polystyrène, et en présence de pénicilline et d'éthanol, ce nombre est passé à 19 et 11 isolats de S. aureus producteurs de biofilm respectivement. En revanche, aucun biofilm ne s'est formé en présence de bétadine. Conclusion: Il est important de tester la formation de biofilm suite à une contrainte externe imposée comme les désinfectants et les antibiotiques afin de développer de nouvelles stratégies pour lutter contre les biofilms bactériens mais aussi pour mieux contrôler leur formation. Mots-clés: Staphylococcus aureus, biofilm, dispositif médical, désinfectant, antibiotique  

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