Efficiency of Operating Room Processes for Elective Cataract Surgeries Done by Residents in a National University Hospital
Received 19 August 2020
Accepted for publication 6 October 2020
Published 28 October 2020 Volume 2020:14 Pages 3527—3533
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Maria Isabel N Umali, Teresita R Castillo
Department of Ophthalmology and Visual Sciences, University of the Philippines Manila, Philippine General Hospital, Manila, Philippines
Correspondence: Maria Isabel N Umali
Asian Eye Institute, 8/F Phinma Plaza, Hidalgo Drive, Rockwell, Makati City 1200, Philippines
Tel +63 917 539 0045
Purpose: Operating room processes must be efficient to boost profitability and minimize cost while retaining surgical care quality. This study aims to assess operating room efficiency for resident-performed elective phacoemulsification surgeries done under local anesthesia by measuring different key performance indicators and comparing this with international benchmark data.
Patients and Methods: This is a prospective cross-sectional study done in the Department of Ophthalmology of the Philippine General Hospital, the National University Hospital. The operating room milestones were noted and recorded by a single third-party observer in randomly selected operating rooms from April to June 2019.
Results: Fifty-six phacoemulsification cases in randomly selected rooms fulfilling both inclusion and exclusion criteria were observed. None of the cases started on or before the scheduled 6:30 a.m. cutting time, with an average of 34 (SD 8.53) minutes late. Entry lag was above the median, while exit lag and turnover time were above the 95th percentile compared to benchmarking data. Segment analysis also showed an increased entry lag (35.11% vs 21.5%), significantly higher than benchmarks (t: 10.99, df: 55, p< 0.01). Comparison with proposed targets in other studies also showed an increased time for entry lag.
Conclusion: This study determined that entry lag is the performance indicator that should be addressed to improve efficiency. A multidisciplinary approach and group goal-setting are needed to implement changes in the operating room.
Keywords: phacoemulsification, health services administration, benchmarking, observational study