Study of the most important factors in the delay of operating room times in Medical Educational Center of Isfahan in 2017

Background and Objective: Delays in the operating room negatively affect both patients and health care workers. Although not all delays directly affect patient health, they often increase anxiety for patients and their families and are a source of frustration for surgeons and other staff. Delays in the operation of the day often lead to conflicts among the involved physicians and nurses. In this study, we analyzed data on perioperative system delays.Materials and Methods: The prospective study is based on the operating room (OR) documentation of four surgical services (general surgery, orthopedic surgery, gynecology, and ear nose throat [ENT] surgery) in Alzahra Hospital of Isfahan over a three-month period. 400 patients undergoing elective surgery with the senior author were entered randomly into an observational study that identified and recorded all errors.We excluded emergency and after-hours cases. The senior author entered all errors into the database immediately after each case. We performed Student t tests for normally distributed variables and Wilcoxon rank-sum tests for variables that were not normally distributed. We set the significance threshold at p < 0.05. We analyzed the data using spss 18.Findings: A total of 200 elective surgical cases were performed during the study period. Delays were the most common type of error (33.6%), and more than half (51.4%) of all cases had at least 1 delay. The most common reasons for delay were surgeon and anesthesiologist unavailability and lack of preparedness of patients. The incision was delayed in more than 70% of the general surgical and orthopedic cases, but less often in gynecological (54 ± 24%) and ENT cases (32 ± 29%). The frequency of delays longer than 10 minutes was between 20% and 40%. The mean delay in delayed cases ranged from 13.1 ± 5.4 to 20.6 ± 8.2 minutes depending on the type of service and process point.Conclusion: This study demonstrates that perioperative delays frequently occur in the operating room and have a major effect on patient flow and resource utilization. Thorough documentation of perioperative delays provides a basis for the development of solutions for improving operating room efficiency and illustrates the principles underlying the causes of operating room delays across surgical disciplines.

Keywords:

Delay , Operating Room , Medical Educational Center