Surgical workflow simulation for the design and assessment of operating room setups in orthopedic surgery.
Discrete event simulation
Operating room management
Surgical process optimization
Surgical workflow simulation
Journal
BMC medical informatics and decision making
ISSN: 1472-6947
Titre abrégé: BMC Med Inform Decis Mak
Pays: England
ID NLM: 101088682
Informations de publication
Date de publication:
02 07 2020
02 07 2020
Historique:
received:
09
08
2019
accepted:
31
03
2020
entrez:
4
7
2020
pubmed:
4
7
2020
medline:
31
12
2020
Statut:
epublish
Résumé
The design and internal layout of modern operating rooms (OR) are influencing the surgical team's collaboration and communication, ergonomics, as well as intraoperative hygiene substantially. Yet, there is no objective method for the assessment and design of operating room setups for different surgical disciplines and intervention types available. The aim of this work is to establish an improved OR setup for common procedures in arthroplasty. With the help of computer simulation, a method for the design and assessment of enhanced OR setups was developed. New OR setups were designed, analyzed in a computer simulation environment and evaluated in the actual intraoperative setting. Thereby, a 3D graphical simulation representation enabled the strong involvement of clinical stakeholders in all phases of the design and decision-making process of the new setup alternatives. The implementation of improved OR setups reduces the instrument handover time between the surgeon and the scrub nurse, the travel paths of the OR team as well as shortens the procedure duration. Additionally, the ergonomics of the OR staff were improved. The developed simulation method was evaluated in the actual intraoperative setting and proved its benefit for the design and optimization of OR setups for different surgical intervention types. As a clinical result, enhanced setups for total knee arthroplasty and total hip arthroplasty surgeries were established in daily clinical routine and the OR efficiency was improved.
Sections du résumé
BACKGROUND
The design and internal layout of modern operating rooms (OR) are influencing the surgical team's collaboration and communication, ergonomics, as well as intraoperative hygiene substantially. Yet, there is no objective method for the assessment and design of operating room setups for different surgical disciplines and intervention types available. The aim of this work is to establish an improved OR setup for common procedures in arthroplasty.
METHODS
With the help of computer simulation, a method for the design and assessment of enhanced OR setups was developed. New OR setups were designed, analyzed in a computer simulation environment and evaluated in the actual intraoperative setting. Thereby, a 3D graphical simulation representation enabled the strong involvement of clinical stakeholders in all phases of the design and decision-making process of the new setup alternatives.
RESULTS
The implementation of improved OR setups reduces the instrument handover time between the surgeon and the scrub nurse, the travel paths of the OR team as well as shortens the procedure duration. Additionally, the ergonomics of the OR staff were improved.
CONCLUSION
The developed simulation method was evaluated in the actual intraoperative setting and proved its benefit for the design and optimization of OR setups for different surgical intervention types. As a clinical result, enhanced setups for total knee arthroplasty and total hip arthroplasty surgeries were established in daily clinical routine and the OR efficiency was improved.
Identifiants
pubmed: 32616031
doi: 10.1186/s12911-020-1086-3
pii: 10.1186/s12911-020-1086-3
pmc: PMC7333415
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
145Références
Lancet. 1999 Mar 20;353(9157):1007-10
pubmed: 10459931
Surg Endosc. 1997 Feb;11(2):139-42
pubmed: 9069145
HERD. 2018 Jul;11(3):124-138
pubmed: 29355033
J Med Syst. 2011 Feb;35(1):1-16
pubmed: 20703590
N Engl J Med. 2004 Apr 1;350(14):1422-9
pubmed: 15070792
Am J Infect Control. 2017 Apr 1;45(4):354-359
pubmed: 28012705
Curr Opin Anaesthesiol. 2006 Apr;19(2):185-91
pubmed: 16552226
HERD. 2012 Spring;5(3):133-44
pubmed: 23002575
Am J Infect Control. 2009 Jun;37(5):387-397
pubmed: 19398246
J Arthroplasty. 2016 Jun;31(6):1194-1198
pubmed: 26791046
Appl Ergon. 2018 Jul;70:288-299
pubmed: 29866321
Chirurg. 2002 Feb;73(2):174-9
pubmed: 11974482
Minim Invasive Ther Allied Technol. 2017 Feb;26(1):31-38
pubmed: 27564687
J Am Assoc Gynecol Laparosc. 1995 Feb;2(2):231-4
pubmed: 9050565
Am J Orthop (Belle Mead NJ). 2012 Mar;41(3):132-9
pubmed: 22530210
Int Arch Occup Environ Health. 1992;63(6):423-8
pubmed: 1544692
AORN J. 2007 Sep;86(3):384-94; quiz 395-8
pubmed: 17822643
Osteoarthritis Cartilage. 2014 Mar;22(3):389-406
pubmed: 24389057
Qual Manag Health Care. 2009 Oct-Dec;18(4):305-14
pubmed: 19851238
Int J Nurs Stud. 2014 Sep;51(9):1195-206
pubmed: 24508284
Int Orthop. 2011 Dec;35(12):1783-9
pubmed: 21404023
Am J Surg. 1971 Sep;122(3):332-43
pubmed: 5570602
Ergonomics. 1994 May;37(5):909-19
pubmed: 8206059
BMJ Qual Saf. 2019 Apr;28(4):276-283
pubmed: 30158119
Appl Ergon. 1977 Dec;8(4):199-201
pubmed: 15677243
Anesthesiology. 2013 Nov;119(5):1066-77
pubmed: 23811697
Health Care Manag Sci. 2010 Jun;13(2):182-91
pubmed: 20629419
Health Care Manag Sci. 2009 Jun;12(2):142-6
pubmed: 19469453
Heart Surg Forum. 2009 Jun;12(3):E125-30
pubmed: 19546059