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Change in Policy Allowing Overlapping Surgery Decreases Length of Stay in an Academic, Safety-Net Hospital
- Source :
- Operative Neurosurgery. 17:543-548
- Publication Year :
- 2019
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2019.
-
Abstract
- Background The practice of surgeons running overlapping operating rooms has recently come under scrutiny. Objective To examine the impact of hospital policy allowing overlapping rooms in the case of patients admitted to a tertiary care, safety-net hospital for urgent neurosurgical procedures. Methods The neurosurgery service at the hospital being studied transitioned from routinely allowing 1 room per day (period 1) to overlapping rooms (period 2), with the second room being staffed by the same attending surgeon. Patients undergoing neurosurgical intervention in each period were retrospectively compared. Demographics, indication, case type, complications, outcomes, and total charges were tracked. Results There were 59 urgent cases in period 1 and 63 in period 2. In the case of these patients, the length of stay was significantly decreased in period 2 (13.09 d vs 19.52; P = .006). The time from admission to surgery (wait time) was also significantly decreased in period 2 (5.12 d vs 7.00; P = .04). Total charges also trended towards less in period 2 (${\$}$150 942 vs ${\$}$200 075; P = .05). Surgical complications were no different between the groups (16.9% vs 14.3%; P = .59), but medical complications were significantly decreased in period 2 (14.3% vs 30.5%; P = .009). Significantly more patients were discharged to home in period 2 (69.8% vs 42.4%; P = .003). Conclusion As a matter of policy, allowing overlapping rooms significantly reduces the length of stay in the case of a vulnerable population in need of urgent surgery at a single safety-net academic institution. This may be due to a reduction in medical complications in these patients.
- Subjects :
- Adult
Male
Waiting time
Operating Rooms
medicine.medical_specialty
Demographics
Neurosurgery
Personnel Staffing and Scheduling
Medicare
Tertiary care
Neurosurgical Procedures
Academic institution
03 medical and health sciences
0302 clinical medicine
Humans
Medicine
Vulnerable population
Academic Medical Centers
Medically Uninsured
Brain Neoplasms
Medicaid
business.industry
General surgery
Interrupted Time Series Analysis
Length of Stay
Middle Aged
Overlapping surgery
Organizational Policy
United States
Wait time
Neurosurgeons
Spinal Injuries
030220 oncology & carcinogenesis
Female
Surgery
Spondylosis
Neurology (clinical)
business
Spinal Cord Compression
Safety-net Providers
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 23324260 and 23324252
- Volume :
- 17
- Database :
- OpenAIRE
- Journal :
- Operative Neurosurgery
- Accession number :
- edsair.doi.dedup.....12cf232bad4d928bdc6ad69ed3aa3b80