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International Orthopaedics

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01-12-2020 | SARS-CoV-2 | Original Paper

Operating room efficiency and timing during coronavirus disease 2019 outbreak in a referral orthopaedic hospital in Northern Italy

Authors: Mauro Andreata, Martina Faraldi, Eugenia Bucci, Giovanni Lombardi, Luigi Zagra

Published in: International Orthopaedics | Issue 12/2020

Abstract

Purpose

The SARS-CoV-2 outbreak affected health care systems at different levels with important consequences on health, economy, and social structures. This paper aims to analyse the impact on surgical block utilisation and efficiency in an orthopaedics reference centre in Northern Italy.

Methods

The timeframe chosen for the current analysis was April 2020, to be compared with the corresponding period in 2019. Number and type of procedures, first case delay, occupancy rate, and turnover time were used as indicators to benchmark the activities.

Results

The overall number of surgical procedures decreased by 57%, from 537 in 2019 to 230 in the same timeframe in 2020. Orthopaedic procedures predominated in 2019, with 434 cases (80.8%), while in 2020, trauma was the leading activity, with 200 cases (86.9%). Orthopaedic surgery had a relative decrement of 93% while trauma has relatively increased by 94%. Mean first case delay in orthopaedic room (OR) was two hours and 36 minutes (SD 01:40:21) in 2020 compared with only 19 minutes (SD 00:02:15) in 2019. OR occupancy rate was 59% in 2020 compared with 89% in 2019. Turnover time raised from 21 minutes in 2019 to 53 min in 2020.

Conclusions

These data clearly show the deep impact of COVID-19 pandemic on OR facilities. Efficiency indicators fell dramatically in April 2020 compared with the corresponding period in 2019. This scenario will deeply affect both the waiting lists and the economic burden of the hospital. Regaining efficiency and maintaining the quality and safety of the process while restoring elective orthopaedic surgery are among the main challenges that surgeons will face in the next time.

https://www.open.online/2020/04/30/coronavirus-bollettino-regione-lombardia-30-aprile/. Accessed 30 April 2020

http://opendatadpc.maps.arcgis.com/apps/opsdashboard/index.html#/b0c68bce2cce478eaac82fe38d4138b1. Accessed 30 April 2020

Randelli PS, Compagnoni R (2020) Management of orthopaedic and traumatology patients during the Coronavirus disease (COVID-19) pandemic in northern Italy. Knee Surg Sport Traumatol Arthrosc. Published online. https://doi.org/10.1007/s00167-020-06023-3

D’Apolito R, Faraldi M, Ottaiano I, Zagra L (2020) Disruption of arthroplasty practice in an orthopaedic center in Northern Italy during COVID-19 pandemic. J Arthroplasty Published online. https://doi.org/10.1016/j.arth.2020.04.057

Zagra L, Faraldi M, Pregliasco F, Vinci A, Lombardi G, Ottaiano I, Accetta R, Perazzo PD (2020) International orthopaedics changes of clinical activities in an orthopaedic institute in North Italy during the spread of COVID-19 pandemic: a seven-week observational analysis. Int Orthop Published online. On line ahead of print. PMID: 32449043. https://doi.org/10.1007/s00264-020-04590-1

Pedron S, Winter V, Oppel EM, Bialas E (2017) Operating room efficiency before and after entrance in a benchmarking program for surgical process data. J Med Syst. 41(151):1–8. https://doi.org/10.1007/s10916-017-0798-0CrossRef

Dexter F, Abouleish AE, Epstein RH, Whitten CW, Lubarsky DA (2003) Use of operating room information system data to predict the impact of reducing turnover times on staffing costs. Anesth Analg. 97(4):1119–1126. https://doi.org/10.1213/01.ANE.0000082520.68800.79CrossRefPubMed

Thaler, M, Kroshavi, I, Hirschmann MT, Zagra L, Epinette, JA, Liebensteiner , MC. (2020) Disruption of joint arthroplasty services in Europe during the COVID - 19 pandemic: an online survey within the European Hip Society (EHS) and the European Knee Associates (EKA). Knee Surg Sport Traumatol Arthrosc doi:https://doi.org/10.1007/s00167-020-06033-1

Oussedik S, Zagra L, Shin GY, D’Apolito R, Haddad F (2020) Reinstating elective orthopaedic surgery in the age of COVID. Bone Joint J 102- B(7):1–4CrossRef

10.

Haddad FS (2020) COVID-19 and orthopaedic and trauma surgery. Bone Joint J 102-B(5):545–546. https://doi.org/10.1302/0301-620X.102B5.BJJ-2020-0552CrossRefPubMed

Title: Operating room efficiency and timing during coronavirus disease 2019 outbreak in a referral orthopaedic hospital in Northern Italy
Authors: Mauro Andreata
Martina Faraldi
Eugenia Bucci
Giovanni Lombardi
Luigi Zagra
Publication date: 01-12-2020
Publisher: Springer Berlin Heidelberg
Keywords: SARS-CoV-2
COVID-19
Published in: International Orthopaedics / Issue 12/2020
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-020-04772-x

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Springer Medicine

Operating room efficiency and timing during coronavirus disease 2019 outbreak in a referral orthopaedic hospital in Northern Italy

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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