Stretcher vs Table for Operative Hand Surgery.

Area of Science:

• Plastic Surgery
• Surgical Efficiency
• Healthcare Operations

Background:

• A Veterans Affairs Medical Center implemented a new protocol for hand surgery patients.
• Patients are now kept on the operating room (OR) stretcher instead of the OR table.
• This initiative aimed to improve OR time efficiency, reduce costs, and maintain patient safety.

Purpose of the Study:

• To evaluate the impact of performing hand surgery on a stretcher versus an OR table.
• Key metrics include OR time efficiency, cost savings, and patient/employee safety.
• The study compared two distinct 1-year periods before and after the protocol change.

Main Methods:

• Retrospective chart review of hand surgery cases performed by the same surgeon.
• Comparison of time intervals: "patient in OR" to "operation begin," "operation end" to "patient out OR," and room turnover time.
• Inquiry to Patient Safety and Employee Health offices for injury reports; analysis of supply costs for transfers.

Main Results:

• A total of 306 surgeries on the table and 191 on the stretcher were analyzed.
• Surgery on the stretcher showed a trend towards reduced time from "in-room to operation begin" (23 vs. 25 minutes) and "operation end to patient out" (3 vs. 4 minutes).
• No patient or employee injuries were reported; supply cost savings of $111.28 per case were observed with stretcher use.

Conclusions:

• Hand surgery can be safely and effectively performed on an OR stretcher.
• This practice leads to significant reductions in both operating room time and associated costs.
• Annual savings are estimated at $57,866 in supply costs and 26 hours of OR time.