[Central induction area. Reduction of non-operative time without additional costs].
BACKGROUND
Induction areas (IA) can lead to more efficient operating sessions through shortening the changeover time between patients. To date IAs have always required additional staff members, whose cost was only partly covered by improvements in productivity. The objective of this project was to demonstrate that a reduction in non-operative time through a newly introduced induction area can be achieved without a need for extra personnel.


METHODS
Non-operative time in 5,963 ENT, orthopedic and cardiac surgical patients from 8 operating theatres were studied for 1 year before and 1 year after the introduction of an induction area. The non-operative time was defined as the time between the end of surgical procedures in one operation and the start of surgical procedures in the next, within regular working hours. Through reallocation of anesthetic nursing and medical staff it was possible to introduce the induction area without increasing staff numbers.


RESULTS
Non-operative time was significantly reduced from 20 min (range 10-30 min) to 14 min (5-25 min). Subgroup analysis showed significant reductions in all specialities: from 10 min (2.5-20 min) to 5 min (0-20 min) in 1,240 cardiac surgical patients, 25 min (20-35 min) to 15 min (5-25 min) in 2,433 ENT patients and 20 min (10-30 min) to 10 min (0-20 min) in 2,290 orthopedic patients. There were no critical incidents attributable to patient handover.


CONCLUSIONS
An induction area can be established and can reduce non-operative time and improve operation theatre throughput without the need for extra personnel. The efficiency of these measures will be increased when the relevant surgical organizational measures are taken to adjust to the faster anesthesiology workflow. The induction area does not lead to a higher rate of critical incidents. To what extent the induction area can be used for structured training of doctors and nurses, remains to be investigated.
Krieg
H
H
Klinik für Anästhesiologie und operative Intensivmedizin, Campus Charité Mitte und Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Berlin.
Schröder
T
T
Grosse
J
J
Hensel
M
M
Volk
T
T
von Heymann
C
C
Bauer
K
K
Bock
R-W
RW
Spies
C D
CD
D000758:Anesthesia; D001071:Appointments and Schedules; D006348:Cardiac Surgical Procedures; D006801:Humans; D016343:Monitoring, Intraoperative; D009873:Operating Rooms / Q000191:economics / Q000458:organization & administration*; D019637:Orthopedic Procedures; D013517:Otorhinolaryngologic Surgical Procedures; D010561:Personnel Staffing and Scheduling; D011182:Postoperative Care; D011183:Postoperative Complications / Q000453:epidemiology; D000078329:Workforce