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Society For Clinical Vascular Surgery

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Developing the Hybrid OR Team - Specialty Specific Staffing Pays Off
Nicolas J. Mouawad, MD MPH MBA RPVI, Kalie Taylor, RN.
McLaren Bay Region / Michigan State University, Bay City, MI, USA.

Service-specific staffing are anticipated to increase operating room (OR) efficiency and employee/surgeon morale which translate into increased operative volume, cost containment, and cost savings. We aimed to evaluate the efficiency of a vascular hybrid operating suite before and after the creation and training of dedicated vascular hybrid operating staff.
A prospective evaluation of current operating room (OR) efficiency was conducted in a newly developed hybrid vascular operating suite. A random selection of 14 days within a 6 week period was selected in a blinded process at baseline and two years following a dedicated hybrid team was installed and trained. An analysis of OR efficiency was conducted by evaluating in-room time, case-time, out-of-room time, turnover, and block utilization. Fiscal analysis, cost containment and cost savings were calculated.
RESULTS: Two time periods were identified - before hybrid team (BHT) and after hybrid team (AHT). A total of 109 cases were identified in the study period, 37 (54% complex) in BHT and 72 (56% complex) in AHT. Delay in morning start time was noted 9 of the of 14 days (64%) or 314 minutes resulting in $19,468 in unutilized time in BHT and 6 of the 14 days (42%) or 104 minutes resulting in $6,448 in AHT. Total time from in-room time until incision between BHT and AHT was 1,295 minutes (21.6hrs; 15.4% of block time; 35 min per case average) and 1,898 min (31.6hrs; 22.5% block; 26.4 avg) resulting in a savings of $534 per case. Total time from end-of-case until out-of-room was 415 minutes (6.9 hours; 5% block; 11.9 avg) in BHT and 602 minutes (10hrs; 7%block;8.4 avg) resulting in $217 per case. Turnover time was 1,248 minutes (20.8 hrs; 15% block) equaling $77,376 in BHT and 1,225 minutes (20.4hrs; 14.6%) equaling $75,950. For turnover, it equaled 34 min per case in BHT ($2108) and 17 min per case in AHT ($1054) with a savings of $1054. Utilized operating block time was 36% BHT and 52% AHT. $1,804 was saved per case in non-operative costs.
The creation and training of a dedicated hybrid vascular OR staff results in significant increases in OR efficiency as well as cost containment and savings for the hospital, including halving the turnover time and doubling case volume.

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