An analysis of surgical and nonsurgical operating room times in high-volume shoulder arthroplasty

Background A significant portion of operating room time in shoulder arthroplasty is devoted to nonsurgical tasks. To maximize efficiency and to increase access to care, it is important to accurately quantify surgical and nonsurgical time for shoulder arthroplasty. This study aimed to evaluate surgic...

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Bibliographic Details
Published in:Journal of shoulder and elbow surgery 2017-06, Vol.26 (6), p.1058-1063
Main Authors: Padegimas, Eric M., MD, Hendy, Benjamin A., MD, Lawrence, Cassandra, BS, Devasagayaraj, Richard, BA, Zmistowski, Benjamin, MD, Abboud, Joseph A., MD, Lazarus, Mark D., MD, Williams, Gerald R., MD, Namdari, Surena, MD, MSc
Format: Article
Language:English
Subjects:
Aged
Arthroplasty, Replacement, Shoulder - methods
Clinical Competence
Female
Humans
Joint Diseases - surgery
Male
Middle Aged
operating room efficiency
Operating Rooms
Operative Time
Orthopedics
overlapping surgery
practice management
prolonged operative time
Retrospective Studies
revision shoulder arthroplasty
Shoulder arthroplasty
Shoulder Joint - surgery
Surgeons - standards
Time Factors
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Summary:Background A significant portion of operating room time in shoulder arthroplasty is devoted to nonsurgical tasks. To maximize efficiency and to increase access to care, it is important to accurately quantify surgical and nonsurgical time for shoulder arthroplasty. This study aimed to evaluate surgical vs. nonsurgical time and to assess the viability of using a 1-surgeon, 2-operating room model. Methods An institutional database was used to identify all primary and revision shoulder arthroplasty cases from February 2011 through December 2013. Time intervals were analyzed, including anesthesia and positioning time, surgical time, conclusion time, and turnover time. Results We identified 1062 shoulder arthroplasties. The average anesthesia and positioning time was 48.2 ± 11.7 minutes, surgical time was 122.7 ± 36.4  minutes, and conclusion time was 10.5 ± 7.0  minutes. Average turnover time at our institution was 40 minutes. An average of 58.8 ± 13.8 minutes (33.2%) of the patient's time in the operating room was not surgical. A 1-room surgical model, with each case following the next, would allow 3 arthroplasties to be performed in a 10-hour surgical day. A 2-room model would allow 4 cases to be performed in a 9-hour surgical day or 5 in an 11-hour day. In this 2-room model, there would be no time in which the surgeon is absent for any surgical portion of the case. Conclusion For a high-volume shoulder arthroplasty practice, a 2-room model leads to greater efficiency and patient access to care without sacrificing the surgeon's presence during surgical portions of the case.
ISSN:1058-2746
1532-6500
DOI:10.1016/j.jse.2016.11.040