title: A robust and non-obtrusive automatic event tracking system for operating room management to improve patient care.
abstract: Optimization of OR management is a complex problem as each OR has different procedures throughout the day inevitably resulting in scheduling delays, variations in time durations and overall suboptimal performance. There exists a need for a system that automatically tracks procedural progress in real time in the OR. This would allow for efficient monitoring of operating room states and target sources of inefficiency and points of improvement.
  
  
  
  We placed three wireless sensors (floor-mounted pressure sensor, ventilator-mounted bellows motion sensor and ambient light detector, and a general room motion detector) in two ORs at our institution and tracked cases 24 h a day for over 4 months.
  
  
  
  We collected data on 238 total cases (107 laparoscopic cases). A total of 176 turnover times were also captured, and we found that the average turnover time between cases was 35 min while the institutional goal was 30 min. Deeper examination showed that 38 % of laparoscopic cases had some aspect of suboptimal activity with the time between extubation and patient exiting the OR being the biggest contributor (16 %).
  
  
  
  Our automated system allows for robust, wireless real-time OR monitoring as well as data collection and retrospective data analyses. We plan to continue expanding our system and to project the data in real time for all OR personnel to see. At the same time, we plan on adding key pieces of technology such as RFID and other radio-frequency systems to track patients and physicians to further increase efficiency and patient safety.
authors.affiliation: Department of Surgery, Houston Methodist Hospital, 6550 Fannin St, Suite 1661, Houston, TX, 77030, USA. ayhuang@houstonmethodist.org.|Methodist Institute of Technology Innovation and Education, Houston, TX, USA. ayhuang@houstonmethodist.org.
authors.forename: Albert Y
authors.identifier: 0000-0002-3116-3852
authors.initials: AY
authors.lastname: Huang
authors.affiliation: LASIE UMR CNRS, Univ., La Rochelle, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Joerger
authors.affiliation: University of Houston, Houston, TX, USA.
authors.forename: Remi
authors.initials: R
authors.lastname: Salmon
authors.affiliation: Department of Surgery, Houston Methodist Hospital, 6550 Fannin St, Suite 1661, Houston, TX, 77030, USA.|Methodist Institute of Technology Innovation and Education, Houston, TX, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Dunkin
authors.affiliation: Department of Surgery, Houston Methodist Hospital, 6550 Fannin St, Suite 1661, Houston, TX, 77030, USA.
authors.forename: Vadim
authors.initials: V
authors.lastname: Sherman
authors.affiliation: Department of Surgery, Houston Methodist Hospital, 6550 Fannin St, Suite 1661, Houston, TX, 77030, USA.
authors.forename: Barbara L
authors.initials: BL
authors.lastname: Bass
authors.affiliation: University of Houston, Houston, TX, USA.|Methodist Institute of Technology Innovation and Education, Houston, TX, USA.|LASIE UMR CNRS, Univ., La Rochelle, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Garbey
mesh_terms: D003695:Delivery of Health Care / Q000458:organization & administration / Q000592:standards; D017598:Efficiency, Organizational / Q000592:standards; D006801:Humans; D010535:Laparoscopy / Q000706:statistics & numerical data; D009873:Operating Rooms / Q000458:organization & administration*; D061214:Patient Safety; D058996:Quality Improvement / Q000458:organization & administration*; D012189:Retrospective Studies; D013997:Time Factors
keywords: Emerging technology; Laparoscopic efficiency; Operating room efficiency; Operating room management; Patient safety; Wireless technology