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Comparison of Operating Room vs Short Procedure Room in a Pediatric Tertiary Hospital

B. Randall Brenn, MD; James S. Reilly, MD; Ellen S. Deutsch, MD; Margaret H. Hetrick, RN, BSN, CNOR; Steven C. Cook, MD

Arch Otolaryngol Head Neck Surg. 2003;129:435-437.

Objective  To compare the operative times of routine otolaryngologic procedures performed with 2 different operating room staffing models: the traditional model with 2 staff, a scrub nurse and a circulator, and the short procedure room (SPR) setting, with a circulator only.

Design  Retrospective comparison of operative procedure times. Data were extracted from a prospectively maintained database of electronic medical records.

Setting  All data were from procedures performed at a tertiary care children's hospital operating room suite.

Patients or Other Participants  Data for the year 2000 were extracted for all outpatient otolaryngology cases of bilateral myringotomy and tube placement (BMT), tonsillectomy and adenoidectomy (TA), and adenoidectomy alone.

Main Outcome Measures  The mean ± SD operative time intervals (operative procedure times and total operative procedure time), anesthesia start times, surgical preparation times, and anesthesia end times of the 2 sites were compared. These time intervals were also compared for the 3 surgeons performing TAs in both settings.

Results  Total operative procedure times were significantly shorter in the SPR setting for TA and BMT, but not for adenoidectomy. For TA procedures, operative procedure times and anesthesia end times were significantly shorter in the SPR setting (P<.05). For BMT procedures, all operative times were significantly shorter in the SPR setting. All 3 surgeons who performed TAs in both settings had significantly shorter total operative procedure times in the SPR setting than in the traditional setting.

Conclusions  Despite fewer assisting staff, the SPR setting showed a statistically significant reduction in total operative procedure times for TA and BMT, and results were similar for adenoidectomy. Reducing operating room personnel costs is possible in addition to achieving modest gains in efficiency.

From the Department of Anesthesiology (Dr Brenn), the Division of Otolaryngology (Drs Reilly, Deutsch, and Cook), and the Department of Nursing (Ms Hetrick), Alfred I. duPont Hospital for Children, Nemours Children's Clinic–Wilmington, Wilmington, Del.

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