title: Working with a fixed operating room team on consecutive similar cases and the effect on case duration and turnover time.
abstract: OBJECTIVE
  If variation in procedure times could be controlled or better predicted, the cost of surgeries could be reduced through improved scheduling of surgical resources. This study on the impact of similar consecutive cases on the turnover, surgical, and procedure times tests the perception that repeating the same manual tasks reduces the duration of these tasks. We hypothesize that when a fixed team works on similar consecutive cases the result will be shorter turnover and procedure duration as well as less variation as compared with the situation without a fixed team.
  
  
  METHODS
  Case-control study.
  
  
  METHODS
  St Franciscus Hospital, a large general teaching hospital in Rotterdam, the Netherlands.
  
  
  METHODS
  Two procedures, inguinal hernia repair and laparoscopic cholecystectomy, were selected and divided across a control group and a study group. Patients were randomly assigned to the study or control group.
  
  
  METHODS
  Preparation time, surgical time, procedure time, and turnover time.
  
  
  RESULTS
  For inguinal hernia repair, we found a significantly lower preparation time and 10 minutes less procedure time in the study group, as compared with the control group. Variation in the study group was lower, as compared with the control group. For laparoscopic cholecystectomy, preparation time was significantly lower in the study group, as compared with the control group. For both procedures, there was a significant decrease in turnover time.
  
  
  CONCLUSIONS
  Scheduling similar consecutive cases and performing with a fixed team results in lower turnover times and preparation times. The procedure time of the inguinal hernia repair decreased significantly and has practical scheduling implications. For more complex surgery, like laparoscopic cholecystectomy, there is no effect on procedure time.
authors.affiliation: Institute of Health Policy and Management, Erasmus University Rotterdam, the Netherlands. stepaniak@bmg.eur.nl
authors.forename: Pieter S
authors.initials: PS
authors.lastname: Stepaniak
authors.forename: Wietske W
authors.initials: WW
authors.lastname: Vrijland
authors.forename: Marcel
authors.initials: M
authors.lastname: de Quelerij
authors.forename: Guus
authors.initials: G
authors.lastname: de Vries
authors.forename: Christiaan
authors.initials: C
authors.lastname: Heij
mesh_terms: D001071:Appointments and Schedules; D001499:Bayes Theorem; D016022:Case-Control Studies; D017081:Cholecystectomy, Laparoscopic / Q000379:methods; D016001:Confidence Intervals; D005260:Female; D019538:Health Care Surveys; D006552:Hernia, Inguinal / Q000601:surgery; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D009426:Netherlands; D009873:Operating Rooms / Q000458:organization & administration*; D010348:Patient Care Team / Q000458:organization & administration*; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration; D011237:Predictive Value of Tests; D015397:Program Evaluation; D016016:Proportional Hazards Models; D011795:Surveys and Questionnaires; D013997:Time Factors; D017749:Total Quality Management; D016526:Workload