Evidence map›Paper›PMID 42120064›Full record

ArticleCanadian journal of surgery. Journal canadien de chirurgie

Improving operating room efficiency for primary joint replacements in a medium-sized rural community hospital using positive deviance seminars.

Nicholas Nucci, Koorosh Kashanian, Matey Juric, Ariane Parisien, Simon Garceau, Andrew Seely, Stéphane Poitras, Paul E Beaulé

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article 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. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

8 authors.

Nicholas NucciFrom the University of Ottawa, Ottawa, Ont. (Nucci, Kashanian, Juric, Poitras); The Ottawa Hospital Research Institute, Ottawa, Ont. (Parisien); The Ottawa Hospital (Garceau, Seely, Beaulé).
Koorosh KashanianFrom the University of Ottawa, Ottawa, Ont. (Nucci, Kashanian, Juric, Poitras); The Ottawa Hospital Research Institute, Ottawa, Ont. (Parisien); The Ottawa Hospital (Garceau, Seely, Beaulé).
Matey JuricFrom the University of Ottawa, Ottawa, Ont. (Nucci, Kashanian, Juric, Poitras); The Ottawa Hospital Research Institute, Ottawa, Ont. (Parisien); The Ottawa Hospital (Garceau, Seely, Beaulé).
Ariane ParisienFrom the University of Ottawa, Ottawa, Ont. (Nucci, Kashanian, Juric, Poitras); The Ottawa Hospital Research Institute, Ottawa, Ont. (Parisien); The Ottawa Hospital (Garceau, Seely, Beaulé).
Simon GarceauFrom the University of Ottawa, Ottawa, Ont. (Nucci, Kashanian, Juric, Poitras); The Ottawa Hospital Research Institute, Ottawa, Ont. (Parisien); The Ottawa Hospital (Garceau, Seely, Beaulé).
Andrew SeelyFrom the University of Ottawa, Ottawa, Ont. (Nucci, Kashanian, Juric, Poitras); The Ottawa Hospital Research Institute, Ottawa, Ont. (Parisien); The Ottawa Hospital (Garceau, Seely, Beaulé).
Stéphane PoitrasFrom the University of Ottawa, Ottawa, Ont. (Nucci, Kashanian, Juric, Poitras); The Ottawa Hospital Research Institute, Ottawa, Ont. (Parisien); The Ottawa Hospital (Garceau, Seely, Beaulé).
Paul E BeauléFrom the University of Ottawa, Ottawa, Ont. (Nucci, Kashanian, Juric, Poitras); The Ottawa Hospital Research Institute, Ottawa, Ont. (Parisien); The Ottawa Hospital (Garceau, Seely, Beaulé). pbeaule@toh.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundImproving operating room (OR) throughput is a constant challenge. Given evidence that positive deviance (PD) sessions to identify excelling individuals and disseminate their strategies lead to improvements in a tertiary care institution, we sought to use PD sessions to increase the success in completing 4 joint arthroplasties in a day in a rural hospital.

methodsWe conducted PD sessions for 13 OR nurses, 4 family physician anesthetists or anesthesiologists, and 2 orthopedic surgeons. Best-performing staff shared strategies. We measured efficiency and agreement, which were then discussed at future PD sessions. Our primary outcome was success in completing 4 joint arthroplasties in a day. We recorded time from the patient being in the OR to anesthesia-ready (anesthesia prep time), time from the patient being anesthesia-ready to surgery start (surgery prep time), procedure length, time from surgery finish to the patient leaving the room (anesthesia finish time), and room turnover time. We collected data before PD sessions (baseline), 1 to 5 months post-PD sessions (short-term follow-up), and 9 to 13 months post-PD sessions (long-term follow-up).

resultsBefore PD sessions, 48.7% of joint arthroplasty days were completed on time. At short- and long-term follow-up, 87.5% and 80.0% were completed on time. The average time to complete 4 cases decreased. Notable changes were made in anesthesia prep time (21 min at baseline, 17 min at both short- and long-term follow-up), and turnover time (30 min at baseline, 25 min at short-term follow-up, 23 min at long-term follow-up).

conclusionOverall, PD sessions in a rural hospital increased success in completing 4 joint arthroplasties in a day with minimal costs, stimulating local strategies for efficiency. Long-term sustainability and applicability to other surgical procedures or specialties is yet to be determined.

Indexed as

Arthroplasty, ReplacementEfficiency, OrganizationalHospitals, CommunityHospitals, RuralOperating RoomsQuality ImprovementHumans

Identifiers

PMID42120064
PMCPMC13189637

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LicenceCC BY-NC-ND
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Registered trials

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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.