Operating Theatre Management System - Essay Example

Running Head: Operating Theatre Management System Operating Theatre Management System s Operating Room Management: An Overview Operating Room Management is the art of how to manage an Operating Room Suite. Operational Operating Room Management concentrates upon make best use of operational effectiveness at the service, i.e. to make best use of the number of surgical cases that can be done on a particular day at the same time as reducing the essential resources and associated expenses. For instance, the number of required anesthetists or nurses that are required to assist the projected workload or to reduce the expenditure of medicines employed in the Operating Room. Strategically Operating Room Management manages long-term decision-making, for instance, the profitability of including extra rooms to the existing facility. In general, Operating Room Management in profit-oriented health-care systems in USA gives emphasis to strategical consideration while in countries with publicly-funded healthcare like the UK; the focus is on operational judgment (McIntosh, Dexter & Epstein 2006). The act of managing and organization all aspects of a surgical suite are to achieve a definite set of objectives. As a budding discipline, operating room management is all the time more examined as how to best: 1) guarantee patient safety and best patient outcome, 2) present surgeons with suitable access to the Operating Room with the aim that patients can have operations in an appropriate way, 3) take full advantage of the competence of operating room utilization, workforce, and resources, 4) reduce patient wait, and 5) augment approval among patients, employees, and doctors. This management skill as employed to the surgical suite is getting more focus as a result of increasing market influence on hospitals from competitors and from customers looking for reduced charges. The surgical suite is generally thought as an advantageous hospital unit. Thus, surgical suites also include a significant portion of hospital budget expenditure. By keeping patient safety constant, the prospect to raise financial increase by means of changing the utilization of already accessible sources is a main goal for managerial study. Incremental efficiency in operating room utilization and operating room efficiency can have significant impacts on hospital workers and resources. Some hospital managers see efficiency in the operating room as throughput, completing the most surgical cases within budget. Later in this article we will provide examples of tools a manager may use to analyze efficiency. The Significance of OR Management Operating expenses consist of, although are not restricted to, the space, know-how and appliances, pharmaceuticals and workforce. Hospital managers have thus focused their interest towards making best use of Operating Room productivity, and consequently hospital productivity, by means of contribution margins. This focus, as well as the increase in demand for promising surgery, has led to a fast development of Operating Room facilities. Traditionally, nurses have been mainly responsible for the daily operation of the surgical suite. All the time more, facilities are employing a physician medical director for the Operating Room, as characterized by a surgeon, anesthesiologist, or both. In some cases, all three fields of surgery, anesthesia, and nursing will be embodied in the daily OR organization infrastructure. By functioning collectively, these three fields can organize all resources crucial to exploit OR efficiency. Since medical requirements and regulatory requirements are frequently changing, the idea of appointing a medical director in the OR, an operating room manager, has gained recognition (Siciliani & Hurst 2005). Clinicians normally focus on operational decisions on the day of surgery for instance moving cases from one Operating Room to another, assigning and replacing staff, prioritizing critical cases, and scheduling add-on case. In contrast, upper management usually concentrates upon strategic decision making viz. whether to launch a new cancer center, or whether to align the hospital with a local healthcare system. Principles of Operating Room Management The assessment made by OR management should have a logical and definitive rationale so as to keep uniformity. In order of precedence, critical principles of OR managers are to: (1) ensure patient wellbeing and the excellence of healthcare; (2) provide surgeons with proper access to the OR; (3) maximize the efficiency of operating room utilization, staff, and resources to decrease expenses; (4) reduce patient wait; and (5) develop approval among patients, personnel, and doctors (Dexter, F et al 1999). If OR management is appropriately functioned in advance, all that physicians and nurses have to consider on the day of surgery is the patient. If management is mediocre, then the medical and nursing staff may squander labors and resources to rush cases or mismanage schedules, as a result compromising focus to the patient safety. Operating Room Productivity Operating room productivity is the amount and value of output from the surgical suite contrary to the amount of input needed. Many establishments consider that output can be achieved without the sacrificial of convenience although these two aspects are not discrete. Generally, the greater the operating room utilization, the less the expediency as described by surgeons and patient. This is because as utilization goes up there is less accessible open staffed OR time offered on short notice. Thus, the greater the access and convenience, the lower is operating room utilization, at least as considered by hospitals staff. This advanced customer service being able to deal with cases promptly is one reason ambulatory surgery centers usually have reduced operating room utilization than big city hospitals. The outpatient surgery center generally has low operating costs as compared to a big city hospital, and thus can financially escape with reduced Operating Room utilization. Primary Customer of Surgical Suite In USA management the OR director identifies the primary customer of the surgical suite. An Operating Room can be completely balanced or it can be biased to one or more its constituents. Here the main people to consider are surgeons, anesthesiologists, nurses, the hospital, and obviously the patient. The surgeons are in large demand with small supply and may outweigh other interests. For instance, a private service may have surgeons who can send their patients to another hospital if made to wait. Moreover, in a private surgery, management may be directed to maintain a particular partner's load of work and the motivations are to plan his/her cases with priority. Similarly, the same supply/demand balance applies to anesthesia. The conditions exist where a particular surgery service will only work with its contracted anesthesia service. Consequently, a manager may have to wait awaiting the contracted anesthesiologist, although this means idle Operating Room time. This can be prevented in establishments where one group has special rights and acquires anesthesia right over all the Operating Rooms. This agreement is seen frequently since it removes factions and simplifies anesthesia situation for cases, either optional or urgent. In USA, hospital-run ORs are recognized by those services where the hospital officials acting as representative for government authorities establish employment and workload. Examples include hospitals in public health care systems like in European countries. In the same way, in other surgical suites, management decisions have patients as the first priority. Facilities performing optional cosmetic measures for cash repayment are an example. As a result of the patient being able to decide where they have plastic surgery, they demand special conditions i.e. first class customer service. Moreover, if a patient is late for surgery the patient will most probably still be undertake surgery. This concept is in contradiction of a big hospital, where a patient who misses its elective surgery is usually removed from the surgery schedule to make room for reshuffled optional and urgent cases. Operating Room Management In Saudi Arabia: A Case Study Research Design & Methodology The aim of this methodology is to define the specialty, to compare between the old and the new methodology of training in anesthesia in Operating Rooms in Saudi Arabia as compared to North America and to give a clear depiction of the past and the predicaments of the anesthetists working in OR in Saudi Arabia, the development of the Residency Training Programs (RTP). Definition of anesthesia and the anesthetist by most dictionaries viz. (Oxford English, Wikipedia 2006; Oxford University Press 2005; Oxford Dictionary 1978, 2004, 2006; Collin Gem English Dictionary 1992; Merriam Webster Online 2006; Encyclopedia Britannica 2006; Wise Geek 2006), does not reveal the complexity of the profession, this gave a bad reflection. The specialist generally worked long hours, confined to the operating theatre, under the control of the surgeon and has no direct contact with the patient. Moreover, the specialty has been marked by high cases of drug and/or alcohol addiction, high rate of suicidal attempts and cross infection. All these were detriment factors that eventually smeared the image of the specialty. Several articles were published dealing with the dilemma facing the specialty (Channa & Seraj 1992 Part 1; Channa & Seraj 1992 Part II, Seraj 1993; Seraj & Channa 1993). The introduction of important class residency training programs and the birth of anesthetic societies were responsible to care and support the specialty, applying the standards of care and examination, and the early experience of medical students to the specialty played all a role. On the other hand, the educators in the medical fields from North America, Europe and Japan innovated and applied new educational training programs. It was a mixture of many old methods. Residents have to experience the system gradually, or what is known as a structured training program. The residents attend normal scheduled educational activities. The major aims of such training programs are to produce well-informed and trained professionals that are capable to provide logical and safe techniques in anesthesia for any patient and to take decisions in cases he/she are unable to provide the decisive proper and safe anesthesia as a result of unsuitable facilities. The new methodology in training became the official and the useful way all over the world, not only for its usefulness but for its wider purpose in preparing the new candidates to understand, absorbs and grasps the amount of cognitive and instructive knowledge given to them in proper doses. This is done through the junior period of two years where the proper teaching of general and local methods of anesthesia for different fields for surgical interferences in OR. The successful resident will continue his/her development in the senior period of two years set for the resident to rotate through the different fields of the anesthetic subspecialties training program. Research Design The survey in Saudi Arabia is provided by three different categories of health care institutions. These are: Ministry Of Health (MOH) It carries the load of providing a different level all over the enormous part of Saudi Arabia. The ministry functions 58.7 % of all hospital beds and is in charge for administration of the private sector hospitals which come to 21.8 % making a total of 80.5 % of the total hospital beds. The ministry's hospitals carry out yearly 409,049 surgical events by 4145 surgeons and the anesthesia services is run by 688 anesthetists (Health statistical year book 2005). Their workload is about 595 cases annually. The bulk of the anesthetic workforce is at the level of specialist and is about 15% at the level of consultant. There are only few hospitals certified by the Saudi commission for the residency training program at the same time they have a far less number of residents. The Private Sector (PS) The private sector has 2108 beds which is about 21.8 % of the total hospital beds. They are mostly run in the main cities. These hospitals carry out 253,308 operations by only 350 professionals or junior consultant anesthetists (Health statistical year book 2005). The benchmark differs from hospital to hospital and from city to city. Each of the anesthetists workload yearly is 724 cases. The hospitals are not certified and have no residents. Other Government Hospitals (OGH) These hospitals surveyed provide the first rate medical care and stand for roughly 19.5 % of the total hospital beds. They perform about 149,006 surgical cases in OR by 411 anesthetists (Health statistical year book 2005). Each has a workload is 363 cases annually. It is regarded far below their counterparts in the other hospitals. It may be regarded to be model workload per year per anesthetist. Some key differences are realized in the service which makes the difference from their counterparts. The daily plan of anesthetic services are assisted by senior staff, the department applies and implement the standard care and monitoring which states to have a consultant covering a single OR and a technician working beside them. Most of these top class hospitals are recognized for the residents to carry out their training under the supervision by the local training committee of the Saudi scientific council for the specialty of anesthesia and intensive care. Findings There are no authoritative statistics on death rate caused by anesthesia in Saudi Arabia, however articles, references and communications newly published (Qadir, Takrouri, Seraj, El-Dawlatly, Al Satli, Al Jasser & Baaj 1998; El-Dawlatly, Takrouri, Thalaj, Khalaf, Hussein & El-Bakry 2004), whilst other articles reveals that MOH and PCHs may have higher death rate than the OGHs (Al Saddique 2004; Sammerkandi 2006). So it is used as a sign of employment of more trainees who are less qualified rather than the experienced senior personnel working in the other government hospitals. For the moment, the standard of care and monitoring which is not applied in the majority of the hospital supports the finding as it spells out compulsory reporting of each OR by a consultant and technician with the advanced equipment and monitoring equipments (Seraj 2006). The western world reduced the death rate to a minimum. A few decades ago, mortality rate as a result of anesthesia was 1-13,000 it fell to 1-200,000 (Lagasso 2002; Eichhorn 1989; Eichhorn 1989; Lunn & Devlin 1987) this was primarily because of several factors. They are: Execution of the standard care and monitoring Restructured policy and practice First Rate residency training programs Broad range of sub-specialties which attract the medical graduates Completion of specific credit hours of the constant medical education Malpractice insurance reporting Enrollment with the medical council and certified license Dynamic participation of the anesthetic societies in setting the advanced practice, defending, protecting the specialty and the specialist. Bibliography Al Saddique, A 2004, 'Medical liability. The dilemma of litigations,' Saudi Medical Journal, vol.25 (7), pp. 901-906. Channa, A & Seraj, M 1992, 'Dilemma of anaesthesiologist working in Saudi Arabia' SAA Newsletter, Part I vol.3 No.4, July. Channa, A & Seraj, M 1992, 'Dilemma of anaesthesiologist working in Saudi Arabia' SAA Newsletter, Part II vol.3 No.4, July. Collin Gem English Dictionary 1992. Dexter, F et al 1999, 'An operating room scheduling strategy to maximize the use of operating room block time: computer simulation of patient scheduling and survey of patients' preferences for surgical waiting time,' Anesth Analg, pp.7-20. Eichhorn, JH 1989, 'Prevention of intraoperative anesthesia accidents & related severe injury through safety monitoring,' Anesthesiology, 70, pp.572-7. El-Dawlatly, AA, Takrouri, MS, Thalaj, A, Khalaf, M, Hussein, WR & El-Bakry, A 2004, 'Critical incident reports in adults: an Analytical Study in a teaching hospital,' M.E. t. J Anesth, Oct, 17(6), pp.1045-54. Encyclopedia Britannica 2006. Health statistical year book 2005, The ministry of health 1725H. Lagasso, RS 2002, 'Anesthesia safety: model or myth' Anesthesiologt, 97, pp.1609-17. Lunn, JN & Devlin 1987, 'Lessons from the confidential inquiry into preoperative death in three NHS regions,' Lancet 2, 1384. Merriam Webster Online 2006. McIntosh C, Dexter F & Epstein, RH 2006, 'Impact of service-specific staffing, case scheduling, turnovers, and first-case starts on anesthesia group and operating room productivity: tutorial using data from an Australian hospital,' Anesth Analg, 103, pp.1499-1516. Oxford Dictionary 1978, 2004, 2006. Oxford English, Wikipedia - The Free Encyclopedia October 2006. Oxford University Press 2005. Qadir, N, Takrouri, MS, Seraj, MA, El-Dawlatly, AA, Al Satli, R, Al Jasser, MM & Baaj, J 1998, 'Critical incident reports,' M.E.J. Anesth Oct;14(6), pp.425-32. Sammerkandi, A 2006, 'Medicolegal liabilities of anaesthesia practice in Saudi Arabia,' M.E.J. Anesth, Vol 18 (4), pp. 693-706. Seraj, M 1993, 'Dilemma of anaesthesiologist working in Saudi Arabia,' Part IV "Recommendation for improvement" SAA Newsletter, vol.4 No.2 April. Seraj, MA 2006, 'Medical litigation in anaesthetic practice in Saudi Arabia,' M.E.J. Anesth, Vol.18 (4), pp.707-716. Seraj, M & Channa, A 1993, 'Quality Assurance and risk management (Malpractice Insurance)' SAA Newsletter, Vol. 4 No. 1 January. Siciliani, L & Hurst, J 2005, 'Tackling excessive waiting times for elective surgery: a comparative analysis of policies in 12 OECD countries,' Health Policy, pp. 201-215. Wise Geek 2006. Read More