Statistical Process Control as a Tool for Controlling Operating Room Performance: Retrospective Analysis and Benchmarking
Resource
JOURNAL OF EVALUATION IN CLINICAL PRACTICE v.16 n.5 pp.905-910
Journal
JOURNAL OF EVALUATION IN CLINICAL PRACTICE
Journal Volume
v.16
Journal Issue
n.5
Pages
905-910
Date Issued
2010
Date
2010
Author(s)
CHEN, TSUNG-TAI
CHANG, YUE-JAU
KU, SHEI-LING
CHUNG, KUO-PIAO
Abstract
There is much research using statistical process control ( SPC) to monitor surgical performance, including comparisons among groups to detect small process shifts, but few of these studies have included a stabilization process. This study aimed to analyse the performance of surgeons in operating room (OR) and set a benchmark by SPC after stabilized process. Methods The OR profile of 499 patients who underwent laparoscopic cholecystectomy performed by 16 surgeons at a tertiary hospital in Taiwan during 2005 and 2006 were recorded. SPC was applied to analyse operative and non-operative times using the following five steps: first, the times were divided into two segments; second, they were normalized; third, they were evaluated as individual processes; fourth, the ARL(0) was calculated;, and fifth, the different groups (surgeons) were compared. Outliers were excluded to ensure stability for each group and to facilitate inter-group comparison. Results The results showed that in the stabilized process, only one surgeon exhibited a significantly shorter total process time ( including operative time and non-operative time). Conclusion In this study, we use five steps to demonstrate how to control surgical and non-surgical time in phase I. There are some measures that can be taken to prevent skew and instability in the process. Also, using SPC, one surgeon can be shown to be a real benchmark.
Subjects
control chart
laparoscopic cholecystectomy
operating room performance
statistical process control
Type
journal article