title: Numbers of simultaneous turnovers calculated from anesthesia or operating room information management system data.
abstract: BACKGROUND
  More personnel are needed to turn over operating rooms (ORs) promptly when there are more simultaneous turnovers. Anesthesia and/or OR information management system data can be analyzed statistically to quantify simultaneous turnovers to evaluate whether to add an additional turnover team.
  
  
  METHODS
  Data collected for each case at a six OR facility were room, date of surgery, time of patient entry into the OR, and time of patient exit from the OR. The number of simultaneous turnovers was calculated for each 1 min of 122 4-wk periods. Our end point was the reduction in the daily minutes of simultaneous turnovers exceeding the number of teams caused by the addition of a team.
  
  
  RESULTS
  Increasing from two turnover teams to three teams reduced the mean daily minutes of simultaneous turnovers exceeding the numbers of teams by 19 min. The ratio of 19 min to 8 h valued the time of extra personnel as 4.0% of the time of OR staff, surgeons, and anesthesia providers. Validity was suggested by other methods of analyses also suggesting staffing for three simultaneous turnovers. Discrete-event simulation showed that the reduction in daily minutes of turnover times from the addition of a team would likely match or exceed the reduction in the daily minutes of simultaneous turnovers exceeding the numbers of teams. Confidence intervals for daily minutes of turnover times achieved by increasing from two to three teams were calculated using successive 4-wk periods. The distribution was sufficiently close to normal that accurate confidence intervals could be calculated using Student's t distribution (Lilliefors' test P = 0.58). Analysis generally should use 13 4-wk periods as increasing the number of periods from 6 to 13 significantly reduced the coefficient of variation of the averages but not increasing the number of periods from 6 to 9 or from 9 to 13.
  
  
  CONCLUSIONS
  The number of simultaneous turnovers can be calculated for each 1 min over 1 yr. The reduction in the daily minutes of simultaneous turnovers exceeding the number of teams achieved by the addition of a turnover team can be averaged over the year's 13 4-wk periods to provide insight as to the value (or not) of adding an additional team.
authors.affiliation: Division of Management Consulting, Department of Anesthesia, University of Iowa, Iowa City, IA 52242, USA. Franklin-Dexter@UIowa.edu
authors.forename: Franklin
authors.initials: F
authors.lastname: Dexter
authors.forename: Eric
authors.initials: E
authors.lastname: Marcon
authors.forename: John
authors.initials: J
authors.lastname: Aker
authors.forename: Richard H
authors.initials: RH
authors.lastname: Epstein
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data; D000776:Anesthesiology / Q000379:methods* / Q000706:statistics & numerical data; D001071:Appointments and Schedules; D006801:Humans; D009870:Operating Room Information Systems / Q000706:statistics & numerical data; D009873:Operating Rooms / Q000379:methods* / Q000706:statistics & numerical data; D010348:Patient Care Team / Q000458:organization & administration; D013503:Surgery Department, Hospital / Q000706:statistics & numerical data; D013997:Time Factors