Operating room planning standards: number of
interventions and annual operating hours to be achieved.
At the time of studying the efficiency of a surgical
block, there are different types of indicators. However, among them, there are
two that are key:
· Number of interventions
per operating room: indicates the degree of utilization of the installed
capacity. Logically this indicator is subject to a certain variability between
centers, since it is conditioned by the greater or lesser complexity of the
surgical interventions (and, therefore, the duration of said interventions).
For this reason, this macro efficiency analysis is usually accompanied by the
percentage of outpatient surgeries.
· Number of annual
opening hours: a poorly monitored indicator in hospitals.
Recommended
standards
At the international level, a series of recommended
standards have been established, specifically on the mentioned criteria:
operations by operating room and opening hours. They are the following:
In
Spain:
· The Ministry of
Health, Social Services and Equality of Spain does not have a maximum capacity
established, but it does propose a recommendation of opening 47 hours per week.
In
France:
· The Ministry of
Health and Social Services of France establishes a capacity of maximum opening
of operating rooms of 54 hours per week and an objective of using 1,000
interventions per operating theater and year.
In the United States there is independent regulation
in each state, although some coincide. The optimum utilization capacity is set
according to the following criteria:
· or about 1,000
(range of 900 to 1,100) interventions per operating room and year
· or about 2,200
hours of operation year: operating hours: 5 days per week, 45-50 weeks per year
(225 to 250 days / year); 9 to 10 hours per day; 80% occupancy)
· The actual mean
of interventions per operating room is 765 patients / year
· To authorize a
new surgical room, a minimum of 800 surgeries per operating room per year must
be demonstrated.
In this sense, we could say that the optimal level
of use should be between 900 and 1,000 interventions per operating room and
year.
Currently the percentage of ambulatory surgery of a
surgical block should be around 50% of surgeries. Since outpatient surgeries
are less complex and of shorter duration, if the percentage of outpatient
surgery is greater, the average number of operations per operating room may be
higher. Thus, in the extreme, an operating room with 100% outpatient surgery
should reach 1,100-1,200 surgeries per year. And vice versa: an operating room
with patients requiring hospitalization will be placed in about 800-900
interventions per year.
Sensitivity
scenarios
Based on these standards, it is necessary to carry
out scenarios of sensitivity of the number of operating theaters according to
the situation of each center and according to the opening hours. The
sensitivity analysis can be based on the hours of operation, and two criteria
can be set:
· Optimal
planning: considers all the elements that affect the ability to perform and
attend a surgical intervention (availability of beds in hospitalization, ICU
and OER, availability of specific equipment for the intervention, availability
of medical personnel, anesthesia, nursing and support with the necessary
competences ...), besides that the surgical activity or typology of the
interventions can vary more than the predicted projections. See more: medical product development
· Optimal use: it
measures the necessary times to perform the maximum number of possible
interventions in an operating room (estimated time of intervention duration,
induction times and awakening of anesthesia, and cleaning and preparation times
between interventions).
Therefore, although the installed capacity of an
operating room allows a certain degree of utilization, it is necessary to plan
to a lesser degree to ensure that the surgical support units absorb the
necessary surgical activity. The optimal degree of planning also allows for growth
capacity in the future.
Comments
Post a Comment