Intraoperative Staff Turnover Linked to Procedural Inefficiency

MONDAY, March 27, 2023 (HealthDay News) — Turnover among operative staff is associated with procedural inefficiency during total joint arthroplasty, according to a study published online March 22 in JAMA Surgery.

Henry C. Cousins, M.Phil., from Stanford Health Care in California, and colleagues examined staff turnover, trainee involvement, and surgeon staff preferences in terms of intraoperative efficiency in a retrospective analysis of all total joint arthroplasties performed by five surgeons at a tertiary academic medical center. A total of 641 cases were included: 279 total hip arthroplasties (THAs) and 362 total knee arthroplasties (TKAs).

The researchers found that in both THAs and TKAs, turnover among circulating nurses correlated with a significant increase in operative duration, with estimated differences of 19.6 and 14.0 minutes of room time, respectively. Significant decreases of 26.5 minutes of procedure time and 12.6 minutes of room time were seen with the presence of a preferred anesthesiologist or surgical technician, respectively, in TKAs. A significant increase in operative duration was seen in association with the presence of a surgeon-preferred vendor in both THAs and TKAs (26.3 and 29.6 minutes, respectively).

“As hospitals refine operating room guidelines and adopt technologies to reduce preventable errors, intentional and regimented management of surgical team dynamics and communication during turnover may represent a powerful and cost-effective tool for improving operative efficiency and patient safety simultaneously,” the authors write.

One author disclosed financial ties to the medical device industry and owns related patents.

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