使用性能边界来评估非OR麻醉 (NORA) 的效率
Justin S Routman1, Erik J Zhang2, Jonathan D Blocker3
1Department of Anesthesiology and Perioperative Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA. jroutman@uabmc.edu.
Journal of medical systems
|July 8, 2025
概括
性能边界揭示了非手术室麻醉 (NORA) 场所的显著效率差异. 需要有针对性的干预措施来优化资源分配和改善NORA的交付.
科学领域:
- 麻醉学 麻醉学
- 医疗保健操作 医疗保健操作
- 性能测量 性能测量 性能测量 性能测量 性能测量
背景情况:
- 手术室 (OR) 套件通常使用性能仪表板来提高效率,但非手术室麻醉 (NORA) 站点面临着独特的挑战.
- 现有的生产力框架不足以指导NORA运营效率的改进.
- 对于极端地区有效的性能边界并未应用于NORA设置.
研究的目的:
- 应用性能边界来评估NORA站点效率.
- 确定改善NORA交付的潜在运营策略.
- 为了评估NORA站点性能的变化.
主要方法:
- 从一家初级医院 (2022年4月至2023年3月) 分析了麻醉费用记录.
- 包括OR和NORA地点的病例,但不包括那些数量或财务安排不规则的病例.
- 计算了未充分利用和过度利用的分钟,并将数据绘制为4周的滚动总和,以预定的NORA区块时间 (非假日周日早上7点至下午5点) 规范化.
- 开发和绘制了性能边界,以可视化效率.
主要成果:
- 在246个工作日内,分析了42 424个病例,其中有20 003个 (47.2%) 是NORA病例和22 421个 (52.8%) 是OR病例.
- 性能边界显示了NORA站点之间显著的效率变化.
- 非参数测试证实了统计学显著性和性能非等价性.
结论:
- 性能边界突出了NORA站点的大量效率变化,需要有针对性的干预措施.
- 一些NORA站点达到OR效率水平,而另一些站点则滞后,特别是那些具有高可变性和紧迫性的站点.
- 有效的网站可以通过性能边界优化资源分配;低效的网站可以从共享资源池中受益.
更多相关视频
相关概念视频
Stages of General Anesthesia
729
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
729
General Anesthesia: Overview
289
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
289
Parenteral Anesthetics: Overview
203
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
203
Inhalational Anesthetics: Overview
534
Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
534
Cardiomyopathy VII: Pre and Post Operative Nursing Management
29
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
29
Assessment of Airway, Skin Color, and Use of Accessory Muscles
1.2K
A thorough assessment of respiratory health is paramount in clinical settings to identify and manage respiratory distress and ensure adequate oxygenation. This article elaborates on the critical aspects of respiratory evaluation, including airway assessment, skin color examination, and the observation of accessory muscle use, which are integral to effectively diagnosing and managing patients with respiratory conditions.
Introduction
The initial evaluation of a patient's respiratory system...
Introduction
The initial evaluation of a patient's respiratory system...
1.2K


