title: A strategy for reducing surgical backlogs: lessons from a veterans administration hospital.
abstract: A process was developed to use a nontraditional operative day (Saturday) to increase the number of inguinal herniorrhaphies (IHs) performed. The purpose of this analysis was to compare operating times and outcomes between patients undergoing IH on Saturday versus the weekday. A retrospective review was conducted that included patients who underwent IH from October 2008 to January 2010. This cohort was divided based on the day on which surgery occurred. The outcome measures were operative times, room turnover time, and complication rates. Operative time was shorter for Saturday IHs (50.7 vs. 67.8 min, P ≤ 0.001). The greatest difference between the two groups occurred in turnover times. We considered Saturday turnover time to be zero, which was possible because of multiple support teams and additional room availability. Turnover times during the week averaged 40.5 ± 2 minutes. There was no difference in complication rates for the two groups (Saturday IHs 17.6% vs. 20.9% for weekday IHs, P = 0.75). Elective cases can be accomplished more rapidly during nontraditional operating times if there are multiple support teams and rooms available.
authors.affiliation: Dallas VA Medical Center, Surgical Services (112), 4500 South Lancaster Road, Dallas, TX 75216, USA. brycew.murray@va.gov
authors.forename: Bryce W
authors.initials: BW
authors.lastname: Murray
authors.forename: Sergio
authors.initials: S
authors.lastname: Huerta
authors.forename: Thomas
authors.initials: T
authors.lastname: Anthony
mesh_terms: D015331:Cohort Studies; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data*; D006552:Hernia, Inguinal / Q000175:diagnosis / Q000601:surgery*; D006787:Hospitals, Veterans / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009873:Operating Rooms / Q000458:organization & administration*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000503:physiopathology; D011786:Quality Control; D012189:Retrospective Studies; D018570:Risk Assessment; D013514:Surgical Procedures, Operative / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D014481:United States; D014850:Waiting Lists; D016526:Workload