提高手术室首台择期手术准时开台方法的探索

Exploration of Methods to Improve the Start on Time of the First Elective Operation in the Operating Room

目的分析全院手术科室首台择期手术准时开台情况,调查延迟开台原因,针对影响首台开台效率的主要原因制定管理措施,实现外科、麻醉、护理衔接紧密,提高效率。方法 (1)运用统计分析方法与实地定性调研方法,统计分析国内某大型三级甲等医院2018年3-10月手术室运行效率与环节耗时,调研导致首台手术延迟开台的主要原因;(2)运用石川图寻找问题根因,对关键延迟原因实施考核,并开发手术进程可视化系统进行效果评价。结果 (1)该院2018年首台择期手术9点10分准时开台率仅为44.7%,平均开台时间为上午9:20,最主要延迟开台原因为"等待医生入室";(2)开展手术准时开台监督考核后,2019年准时开台率提升至96.8%,平均开台时间提前至上午8:59。结论提高首台手术准时开台率的关键在于提高外科医生的效率。

Objective To analyze the timely opening of the first elective surgery in the surgical department of the whole hospital,investigate the reasons for delaying the opening of the platform,and formulate management measures for the main reasons affecting the efficiency of opening the first platform,so as to realize the close connection between surgery,anesthesia and nursing and improve the efficiency.Methods(1)Using statistical analysis method and field qualitative investigation method,the operating efficiency and link time consumption of an operating room in a large third-class first-class hospital in China from March to October 2018 were statistically analyzed,and the main reasons for the delay in opening the first operation were investigated.(2)Using Ishikawa diagram to find the root cause of the problem,check the key delay reasons,and develop the visualization system of the operation process to evaluate the effect.Results(1)The opening rate of the first elective surgery in our hospital at 9:10 in 2018 was only 44.7%,and the average opening time was 9:20 in the morning.The main reason for delaying the opening was“waiting for the doctor to enter the room”.(2)After carrying out the supervision and assessment of the timely opening of the surgery,the timely opening rate of the surgery was increased to 96.8% from 2019,and the average opening time was advanced to 8:59 am.Conclusion The key to improving the on-time opening rate of the first operation is to improve the efficiency of the surgeons.