Evidence map›Paper›PMID 36347535›Full record

Trial reportCanadian journal of surgery. Journal canadien de chirurgie

Evaluation of a tiered operating room strategy at an academic centre: comparing high-efficiency and conventional operating rooms.

Moaz Chohan, Aurelia Bihari, Christina Tieszer, Melanie MacNevin, Cheryl Churcher, Cathy Vandersluis, Florence Cassar, Cheng Lin, Emil Schemitsch, David Sanders and 1 more

Open access · diamondAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Canadian journal of surgery. Journal canadien de chirurgie. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.7field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 1 institution in 1 country.

Moaz ChohanDepartment of Surgery (Chohan, Bihari, Schemitsch, Sanders, Lawendy), Schulich School of Medicine, University of Western Ontario; Division of Orthopaedic Surgery (Bihari, Tieszer, MacNevin, Schemitsch, Sanders, Lawendy) and Perioperative Services (Churcher, Vandersluis, Cassar), and Department of Anaesthesia (Lin), London Health Sciences Centre, London, Ont.
Aurelia BihariDepartment of Surgery (Chohan, Bihari, Schemitsch, Sanders, Lawendy), Schulich School of Medicine, University of Western Ontario; Division of Orthopaedic Surgery (Bihari, Tieszer, MacNevin, Schemitsch, Sanders, Lawendy) and Perioperative Services (Churcher, Vandersluis, Cassar), and Department of Anaesthesia (Lin), London Health Sciences Centre, London, Ont. relka.bihari@lhsc.on.ca.
Christina TieszerDepartment of Surgery (Chohan, Bihari, Schemitsch, Sanders, Lawendy), Schulich School of Medicine, University of Western Ontario; Division of Orthopaedic Surgery (Bihari, Tieszer, MacNevin, Schemitsch, Sanders, Lawendy) and Perioperative Services (Churcher, Vandersluis, Cassar), and Department of Anaesthesia (Lin), London Health Sciences Centre, London, Ont.
Melanie MacNevinDepartment of Surgery (Chohan, Bihari, Schemitsch, Sanders, Lawendy), Schulich School of Medicine, University of Western Ontario; Division of Orthopaedic Surgery (Bihari, Tieszer, MacNevin, Schemitsch, Sanders, Lawendy) and Perioperative Services (Churcher, Vandersluis, Cassar), and Department of Anaesthesia (Lin), London Health Sciences Centre, London, Ont.
Cheryl ChurcherDepartment of Surgery (Chohan, Bihari, Schemitsch, Sanders, Lawendy), Schulich School of Medicine, University of Western Ontario; Division of Orthopaedic Surgery (Bihari, Tieszer, MacNevin, Schemitsch, Sanders, Lawendy) and Perioperative Services (Churcher, Vandersluis, Cassar), and Department of Anaesthesia (Lin), London Health Sciences Centre, London, Ont.
Cathy VandersluisDepartment of Surgery (Chohan, Bihari, Schemitsch, Sanders, Lawendy), Schulich School of Medicine, University of Western Ontario; Division of Orthopaedic Surgery (Bihari, Tieszer, MacNevin, Schemitsch, Sanders, Lawendy) and Perioperative Services (Churcher, Vandersluis, Cassar), and Department of Anaesthesia (Lin), London Health Sciences Centre, London, Ont.
Florence CassarDepartment of Surgery (Chohan, Bihari, Schemitsch, Sanders, Lawendy), Schulich School of Medicine, University of Western Ontario; Division of Orthopaedic Surgery (Bihari, Tieszer, MacNevin, Schemitsch, Sanders, Lawendy) and Perioperative Services (Churcher, Vandersluis, Cassar), and Department of Anaesthesia (Lin), London Health Sciences Centre, London, Ont.
Cheng LinDepartment of Surgery (Chohan, Bihari, Schemitsch, Sanders, Lawendy), Schulich School of Medicine, University of Western Ontario; Division of Orthopaedic Surgery (Bihari, Tieszer, MacNevin, Schemitsch, Sanders, Lawendy) and Perioperative Services (Churcher, Vandersluis, Cassar), and Department of Anaesthesia (Lin), London Health Sciences Centre, London, Ont.
Emil SchemitschDepartment of Surgery (Chohan, Bihari, Schemitsch, Sanders, Lawendy), Schulich School of Medicine, University of Western Ontario; Division of Orthopaedic Surgery (Bihari, Tieszer, MacNevin, Schemitsch, Sanders, Lawendy) and Perioperative Services (Churcher, Vandersluis, Cassar), and Department of Anaesthesia (Lin), London Health Sciences Centre, London, Ont.
David SandersDepartment of Surgery (Chohan, Bihari, Schemitsch, Sanders, Lawendy), Schulich School of Medicine, University of Western Ontario; Division of Orthopaedic Surgery (Bihari, Tieszer, MacNevin, Schemitsch, Sanders, Lawendy) and Perioperative Services (Churcher, Vandersluis, Cassar), and Department of Anaesthesia (Lin), London Health Sciences Centre, London, Ont.
Abdel-Rahman LawendyDepartment of Surgery (Chohan, Bihari, Schemitsch, Sanders, Lawendy), Schulich School of Medicine, University of Western Ontario; Division of Orthopaedic Surgery (Bihari, Tieszer, MacNevin, Schemitsch, Sanders, Lawendy) and Perioperative Services (Churcher, Vandersluis, Cassar), and Department of Anaesthesia (Lin), London Health Sciences Centre, London, Ont.
Western University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWait times for many elective orthopedic surgical procedures in Ontario have become unacceptably long and substantially exceed the recommended guidelines. As a consequence, many patients experience chronic pain, disability and other poor health outcomes. The purpose of this study was to test a novel, resource-saving redesign of outpatient operating room (OR) services, based on tiered grouping of surgical cases, to maximize health benefits for patients while improving efficiency and decreasing wait times.

methodsThis prospective cohort study enrolled adult patients scheduled to undergo unilateral lower limb procedures that had a low requirement for surgical resources and did not require admission to the hospital (ambulatory surgical services) at an academic hospital. Patients were randomly assigned to a conventional OR group or a high-efficiency (tiered) OR group, in which the intensity of surgical, anesthesia and nursing resources was matched to the procedure and the patient's health status. The tiered OR made use of local anesthesia and a block room rather than general anesthesia. Primary outcomes were costs of surgical services provided and patient health outcomes; secondary outcomes were patient and staff satisfaction with each OR setup.

resultsThe costs associated with the high-efficiency OR were 60% lower than those associated with the conventional OR (this was primarily due to the streamlining of OR care and elimination of the need to use a postanesthetic care unit), with the same or equivalent patient health outcomes. No differences in patient and staff satisfaction were found between the 2 setups.

conclusionThe use of tiered, ambulatory services for elective orthopedic surgery does not compromise health outcomes and patient satisfaction, and it is associated with substantial cost savings.

Indexed as

Elective Surgical ProceduresOperating RoomsAdultAnesthesia, GeneralEfficiencyHumansProspective Studies

Identifiers

PMID36347535
PMCPMC9648662
OpenAlexW4308509786

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.