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Ben-Zvi, Noa. "(OR)² : operations research applied to operating room supply chain". Thesis, Massachusetts Institute of Technology, 2014. http://hdl.handle.net/1721.1/91096.
Pełny tekst źródłaThesis: M.B.A., Massachusetts Institute of Technology, Sloan School of Management, 2014. In conjunction with the Leaders for Global Operations Program at MIT.
Cataloged from PDF version of thesis.
Includes bibliographical references (page 63).
Massachusetts General Hospital (MGH) is ranked as the top hospital in New England and second nation-wide. It is also the largest hospital in New England; it uses an average of 58 operating rooms, where approximately 150 surgical procedures are performed daily. Management of surgical supplies is a critical component of the processes supporting this infrastructure. Specifically, ensuring the right equipment and supplies are available at the right time is critical for the efficiency and quality outcomes of each of the procedures. The materials management group handles over 10,000 unique items, purchased from more than 400 vendors. The majority (60-70%) of disposable supplies are ordered through Owens & Minor, a medical and surgical supplies distributor. The supplies are stored in multiple locations throughout the hospital, including two central locations as well as carts and cabinets on the surgical floors and in the operating rooms. The work described in this thesis focuses on the inventory management of disposable surgical supplies, where the current system design has inefficiencies in the inventory levels and location of items. Using a data-driven approach, based on historical demand, we calculate base stock levels by item that maintain three days of inventory at a 99 percent service level. In addition, we suggest a methodology to support decisions on inventory locations of the different items. Implementation of the recommended changes is estimated to result in savings of 30-40% in inventory levels (and space), corresponding to a one time saving of $700,000-$900,000, depending on the implementation scenario. In addition, the reduction in inventory levels can be translated to future savings in inventory holding costs at an estimated 40% rate, leading to a saving of roughly $300,000 annually.
by Noa Ben-Zvi.
S.M.
M.B.A.
Eakin, Sherri. "Operating room nurses and surgical technologists perceptions of job satisfaction in the operating room environment". Thesis, University of Phoenix, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10024192.
Pełny tekst źródłaThe predicted future operating room nurse and surgical technologist shortages may have significant implications for the healthcare industry. Improving the job satisfaction of operating room personnel could promote retention and provide adequate staffing in operating rooms. The job satisfaction of operating room nurses and surgical technologists can result in positive or negative work environments. The purpose of the qualitative phenomenological study was to explore the perceptions of job satisfaction of operating room nurses and surgical technologists to discover how job satisfaction influences the intent to leave or remain in the work environment of the operating room. A purposive selection was made of 12 registered nurses and 12 surgical technologists who had varying degrees of experience in the healthcare field, and were working part time or full time in the operating room of a pediatric medical center in North, Texas. Interviews were audio-recorded and the seven steps were used from Moustakas van Kaam analysis to reveal themes and patterns from the research data. Six themes emerged from the research study that included teamwork, recognition from surgeon, working with pediatric patients and their families, staff appreciation, work environment, and executive leadership. Based on the findings, further research is needed to ascertain strategies that would improve operating room registered nurses and surgical technologists’ job satisfaction and retention.
Parker, Sarah Henrickson. "Surgeons' leadership in the operating room". Thesis, University of Aberdeen, 2011. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=174680.
Pełny tekst źródłaShahabiKargar, Zahra. "Intelligent Scheduling for Hospital Operating Rooms". Thesis, Griffith University, 2016. http://hdl.handle.net/10072/367615.
Pełny tekst źródłaThesis (PhD Doctorate)
Doctor of Philosophy (PhD)
Institute for Integrated and Intelligent Systems
Science, Environment, Engineering and Technology
Full Text
Grange, Sébastien. "M/ORIS - Medical / Operating Room Interaction System /". Lausanne : EPFL, 2007. http://library.epfl.ch/theses/?nr=3798.
Pełny tekst źródłaClapham, Michael Charles Cornell. "Learning to teach in the operating room". Thesis, University of Birmingham, 2008. http://etheses.bham.ac.uk//id/eprint/186/.
Pełny tekst źródłaNeveling, Christoffel Hermanus. "Battlefords Union Hospital operating room suite efficiency review". Thesis, Stellenbosch : University of Stellenbosch, 2007. http://hdl.handle.net/10019.1/883.
Pełny tekst źródłaENGLISH ABSTRACT: Given the increase in the cost of health care, economic considerations have drawn more and more interest over the last decade. Facilities are faced with the challenge to reduce costs while maintaining productivity. The Operating Room (OR) represents a significant opportunity to reduce expenses and improve efficiency. With the development of ambulatory or day surgery, minimally invasive procedures and the decline in admissions to hospitals the management of the OR suite needs re-evaluation. The Battlefords Union Hospital has a four room OR suite that performs a mixture of both inhospital and day surgeries. The current OR suite efficiency is determined by its adherence to the annual budget. A literature study was conducted with the focus on OR efficiency and in particular Patient Outcome and OR Management. Other issues included Perioperative Information systems and OR design. A survey was conducted in the OR suite and responses obtained from OR staff were evaluated. The survey included questions on patient experiences, procedural times, case scheduling, support, communication, quality measures and OR efficiency. The goals of this project was not to do an extensive statistical analysis of OR data. A limited study of OR suite data was presented to highlight relevant OR efficiency indicators. A summary of the findings and recommendations for improvement of the Battlefords Union Hospital OR suite’s efficiency, concludes the report.
AFIKAANSE OPSOMMING: Na aanleiding van die verhoging in koste van gesondheidsorg die laaste dekade, is ekonomiese aspekte meer op die voorgrond. Inrigtings word deur uitdagings in die gesig gestaar om kostes te verminder, terwyl produktiwiteit gehandhaaf moet word. Die operasie suite bied ‘n aansienlike geleentheid om kostes te verminder en effektiwiteit te verhoog. Met die ontwikkeling van dagchirurgie, “minimal invasive” prosedures en die afname in hospitaal opnames, behoort die bestuur van operasie suites herevalueer te word. Die Battlefords Union Hospitaal het ‘n vier teater operasie suite waar ‘n verskeidenheid van dagchirurgie en in-hospitaal prosedures uitgevoer word. Die operasie suite se effektiwiteit word huidiglik slegs gemeet aan die mate van hoe dit binne die jaarlikse begroting bly. ‘n Literatuurstudie is uitgevoer met die fokus op operasie suite effektiwiteit, met die klem op pasient uitkoms en operasie suite bestuur. Ander items wat ook ondersoek is, sluit in perioperatiewe informasie stelsels en teater ontwerp. ‘n Empiriese studie, gebaseer op ‘n vraelys, is uitgevoer onder die staflede van die operasie suite by die Battlefords Union Hopitaal. Die vraelys het vrae ingesluit oor pasient ervarings, prosedure tye, geval skedulering, kommunikasie, kwaliteitsversekering en operasie suite effektiwiteit. Die doel van die projek was nie om ‘n uitgebreide statistiese analise van die operasie suite data te doen nie. 'n Beperkte studie van die beskikbare data is gedoen en relevante effektiwiteits indikators is uitgewys. Die verslag word afgeëindig deur bevindinge, gevolgtrekkings en aanbevelings oor hoe die Battlefords Union Hospitaal die operasie suite se effektiwiteit moontlik kan verhoog.
Davies, Samuel Ingraham 1980. "Machine learning at the operating room of the future : a comparison of machine learning techniques applied to operating room scheduling". Thesis, Massachusetts Institute of Technology, 2004. http://hdl.handle.net/1721.1/28379.
Pełny tekst źródłaIncludes bibliographical references (leaves 48-50).
The quality of an operating room schedule is determined by the accuracy of the surgery duration estimation used. State of the art estimation algorithms consider only three surgery variables-procedure type, surgeon identity, and date of surgery-to predict the length of surgeries. We show that if we can take advantage of a richer set of available information, we can significantly improve estimation accuracy. Additional recorded (but unused) variables include patient age, gender, and morbidity, anesthesiologist identity, and surgery location. We implement and compare the accuracy of four standard machine learning algorithms that take advantage of this richer data set: linear regression, nearest neighbors, regression trees, and support vector regression. We conclude that additional variables can improve the accuracy estimate by as much as 20%. Finally, we discuss the implementation challenges and future work necessary to make machine learning techniques available to the data analyst concerned with implementation. Portions of this work are sponsored by the U.S. Dept. of the Army, under DAMD 17-02- 2-0006. The information does not necessarily reflect the position of the government, and no official endorsement should be inferred.
by Samuel Ingraham Davies.
M.Eng.
Gillespie, Brigid Mary, i N/A. "The Predictors of Resilience in Operating Room Nurses". Griffith University. School of Nursing and Midwifery, 2007. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20070824.123750.
Pełny tekst źródłaAl-Ojaimi, Abdulkarim. "Evidence based models for evaluating operating room performance". Thesis, Cardiff University, 2012. http://orca.cf.ac.uk/47338/.
Pełny tekst źródłaSadeghian, Parastoo. "A new generation of hospital operating room ventilation". Licentiate thesis, KTH, Hållbara byggnader, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-284542.
Pełny tekst źródłaInfektioner relaterade till kirurgiskt ingrepp utgör 38 % av rapporterade infektioner efter operation. Dessa infektioner ökar dödligheten och behandlingskostnaderna samt förlänger patienternas sjukhusvistelse. Bakteriebärande partiklar är den främsta orsaken till infektion vid kirurgi. Huvudkällan till dessa partiklar är hudfragment som frigörs från kirurgisk personal under en pågående operation. Genom att tillföra ren luft via ventilationssystemet kan koncentrationen av baktebärande partiklar i operationssalen minskas. Ventilationssystemets förmåga att ventilera salen påverkas av föremål som stör luftströmmen, som exempel medicinsk utrustning, kirurgiska lampor samt av närvarande personal och deras beteende under operationen. Med avancerade numeriska strömningsberäkningar undersöks i denna avhandling luftflöden och fördelningen av föroreningar i operationssalen under inverkan av sådana störningar. Tre olika ventilationssystem inkluderas. Ett för laminärt luftflöde, ett för turbulent omblandning och ett för temperaturreglerad luftströmning. I studien kartläggs ventilationssystemens funktion och relevansen prövas i ett kontinuerligt samarbete med tillverkande industri. Användning av värmefiltar förekommer under större operationer för att hålla patientens kroppstemperatur stabil. Det finns emellertid en stor oro för att dessa filtar stör det tillförda luftflödet och därmed ökar föroreningsnivån. En vanlig typ av värmefilt med forcerad varmluft kan om den är förorenad avsevärt öka koncentrationen av bakteriebärande partiklar i sårområdet. De flesta undersökningar om värmande filtar är kliniska studier och det är fortfarande inte helt klarlagt i vilken mån och hur dessa filtar skall användas. Denna studie visar emellertid att användning av värmefiltar inte påverkar föroreningsnivån i den kirurgiska zonen. Gjorda datorsimuleringar av luftflödesfältet och partikelspårning visar att det laminära ventilationsflödet lättare störs av lokala värmebelastningarna än av generella värmebelastningar i operationssalen. Kirurgiska lampor betraktas som hinder i en planerad luftflödesväg. Lampor kan skapa en stillastående luftmassa ovanför operationsbordet och därmed öka föroreningsnivån. För detta introduceras en ny design av kirurgisk lampa, en fläktmonterad kirurgisk lampa för operationsrum, utrustade med laminärt luftflöde och omblandning. Simulerade resultat visar att denna nya kirurgiska lampa signifikant minskar föroreningsnivån vid operationsbordet. Visualiseringsteknik användes i denna studie för att förbättra förståelsen hos kirurgisk personal om hur förorenade partiklar kan spridas i operationssalen. Med ett virtuellt och förstärkt gränssnitt visualiserades föroreningshalter i rumsluften då olika typer av ventilationssystem användes. Visualiseringen visar också hur kirurgigruppens storlek och arbetsställning under operation påverkar spridningen av föroreningar.
QC 20201103
Stevenson, Tyler C. "Experimental investigation of hospital operating room air distribution". Thesis, Atlanta, Ga. : Georgia Institute of Technology, 2008. http://hdl.handle.net/1853/22574.
Pełny tekst źródłaGillespie, Brigid Mary. "The Predictors of Resilience in Operating Room Nurses". Thesis, Griffith University, 2007. http://hdl.handle.net/10072/365391.
Pełny tekst źródłaThesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Nursing and Midwifery
Full Text
Taylor, Leah Kristine. "Objective measures of operating room wire navigation performance". Thesis, University of Iowa, 2016. https://ir.uiowa.edu/etd/5656.
Pełny tekst źródłaOgunjulugbe, Jacqueline P. "Decreasing Operating Room Delays for Surgical Orthopedic Patients". ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/6078.
Pełny tekst źródłaWoldehawariat, Negat. "Experiences of operating room nurses in their work environment at a state hospital in Ethiopia". Thesis, Nelson Mandela Metropolitan University, 2012. http://hdl.handle.net/10948/d1008177.
Pełny tekst źródłaVan, Heerden Christelle. "Support for operating room personnel after a sharps injury / Christelle van Heerden". Thesis, North-West University, 2007. http://hdl.handle.net/10394/1897.
Pełny tekst źródłaPrince, Jacqueline Yvonne. "Operating room nursing science learning programmes in South Africa". Thesis, Nelson Mandela Metropolitan University, 2007. http://hdl.handle.net/10948/594.
Pełny tekst źródłaLoy, Rodas Nicolas. "Context-aware radiation protection for the hybrid operating room". Thesis, Strasbourg, 2018. http://www.theses.fr/2018STRAD001/document.
Pełny tekst źródłaThe use of X-ray imaging technologies during minimally-invasive procedures exposes both patients and medical staff to ionizing radiation. Even if the dose absorbed during a single procedure can be low, long-term exposure can lead to noxious effects (e.g. cancer). In this thesis, we therefore propose methods to improve the overall radiation safety in the hybrid operating room by acting in two complementary directions. First, we propose approaches to make clinicians more aware of exposure by providing in-situ visual feedback of the ongoing radiation dose by means of augmented reality. Second, we propose to act on the X-ray device positioning with an optimization approach for recommending an angulation reducing the dose deposited to both patient and staff, while maintaining the clinical quality of the outcome image. Both applications rely on approaches proposed to perceive the room using RGBD cameras and to simulate in real-time the propagation of radiation and the deposited dose
Levesque, Marie-Julie. "Interprofessional Collaboration in the Operating Room: A Nursing Perspective". Thesis, Université d'Ottawa / University of Ottawa, 2021. http://hdl.handle.net/10393/42751.
Pełny tekst źródłaYoo, Seung-jin. "Micromachined wavelength selective microbolometer sensors operating at room temperature /". Full text (PDF) from UMI/Dissertation Abstracts International, 2000. http://wwwlib.umi.com/cr/utexas/fullcit?p3004406.
Pełny tekst źródłaRutherford, John. "Development of a behavioural rating system for the non-technical skills used by anaesthetic nurses and operating department practitioners". Thesis, University of Aberdeen, 2015. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=225952.
Pełny tekst źródłaDÍAZ, CÉSAR DAVID LÓPEZ. "OPERATING ROOM SCHEDULING TO ELECTIVE PATIENTS, AN INTEGER PROGRAMMING MODEL". PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIRO, 2015. http://www.maxwell.vrac.puc-rio.br/Busca_etds.php?strSecao=resultado&nrSeq=25684@1.
Pełny tekst źródłaCOORDENAÇÃO DE APERFEIÇOAMENTO DO PESSOAL DE ENSINO SUPERIOR
PROGRAMA DE SUPORTE À PÓS-GRADUAÇÃO DE INSTS. DE ENSINO
As despesas anuais em saúde para a maioria dos países são crescentes. Segundo a Organização Mundial de Saúde (OMS), em 2011 o Brasil gastou aproximadamente 10 porcento do produto interno bruto em saúde. Consequentemente, incrementar a eficiência na prestação de serviços médicos está se tornando cada vez mais importante. Em um hospital as salas de cirurgia representam um dos principais centros de custos e de rendimentos. As salas de cirurgia são um aspecto difícil de gerenciar devido à prioridade das partes envolvidas no processo, nomeadamente, pacientes, cirurgiões, staff, pessoal administrativo, e a escassez de recursos como leitos, salas de cirurgia, equipamentos especiais, etc. A presente dissertação aborda um problema real de programação de salas de cirurgia para pacientes eletivos de um hospital em Lisboa, onde é proposta uma reformulação do modelo de PLI proposto por Marques et al. (2012). Esta reformulação é baseada no problema da mochila, com o objetivo de encontrar soluções mais eficientes em termos computacionais. De acordo com os testes realizados, uma modificação no modelo que quebre sua simetria além de fornecer uma solução mais eficiente computacionalmente, melhora a solução original pois diminui o gap inicial de 782,59 porcento para 2,25 porcento. Também foi proposto um modelo de simulação no que foram criados vários cenários para avaliar a incerteza envolvida, nos quais a duração média das cirurgias foi submetida a valores majorados. Esta simulação pode servir como ferramenta de apoio na tomada de decisões, pois de acordo com o grau de conservadorismo de quem toma as decisões, podem ser estabelecidas políticas de programação das Salas de Cirurgia.
For most countries annual health expenditures are increasing. According to the World Health Organization (WHO), in 2011, Brazil expends about 10 percent of its gross domestic product on health. Hence, improving health care efficiency is becoming increasingly important. Within a hospital, the Operating Rooms represent a major cost and incomes center. Operating Rooms are a difficult aspect to manage because many stakeholders involved in the process, namely, patients, surgeons, staff, hospital manager, and the scarcity of resources like beds, operating rooms, especial equipment, etc. This dissertation deals with a real problem of operating rooms programming for elective patients in a Lisbon hospital. For this problem, we propose a reformulation of the integer programming model proposed by Marques et al. (2012). This reformulation is based on the knapsack problem, in order to find a more efficient solution in terms of time. According to tests carried out, a reformulation in the model that breaks symmetry, computationally provides a more efficient solution and enhance the original solution because it reduces the initial gap from 782.59 percent to 2.25 percent. In addition, a simulation model was proposed to create various scenarios to assess the involved uncertainty, mainly due to surgery duration variation. This simulation can serve as a support tool in decision-making, according to the degree of conservatism of the decision maker, Operating Rooms scheduling policies can be established.
Sadrizadeh, Sasan. "Design of Hospital Operating Room Ventilation using Computational Fluid Dynamics". Doctoral thesis, KTH, Strömnings- och klimatteknik, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-181053.
Pełny tekst źródłaTidigt i mänsklighetens utveckling har kirurgin funnits med i bilden. Hantering av infektioner har genom tiderna varit en oundviklig del av alla kirurgiska ingrepp, och finns kvar ännu idag som en viktig utmaning i operationssalar på sjukhus. För patienter som genomgår kirurgi finns alltid en risk att de efter ingreppet utvecklar någon behandlingsrelaterad komplikation. Allmänt accepterat är att de luftburna bakterier som når operationsområdet huvudsakligen består av stafylokocker frigjorda från hudfloran av operationspersonalen i operationssalen, och att endast en liten del av dessa partiklar behövs för att initiera en allvarlig infektion i det behandlade området. Sårinfektioner innebär inte bara en enorm börda för hälso- och sjukvårdsresurser, utan utgör också en betydande risk för patienten. På sjukhus förvärvad infektion finns bland de främsta dödsorsakerna i kirurgiska patientgrupper.. En bred kunskap och förståelse av spridningsmekanismer och källor till infektionsspridande partiklar kan ge värdefulla möjligheter att kontrollera och minimera postoperativa infektioner. Denna avhandling bidrar till lösningar genom analys av en rad olika ventilationssystem tillsammans med undersökning av andra faktörer som kan påverka infektionsspridningen på sjukhus, främst i operationssalar. Syftet med arbetet är att med hjälp av CFD-teknik (Computational Fluid Dynamics) få bättre förståelse för olika luftspridningsmekanismers betydelse vid ventilation av operationssalar och vårdinrättningar på sjukhus, så att halten av bacteriebärande partiklar i luften kan minskas samtidigt som termisk komfort och luftkvalité förbättras. Flera luftflödesprinciper för ventilation inklusive omblandade strömning, riktad (laminär) strömning och hybridstrategier har studerats. Simuleringar av luft-, partikel- och spårgasflöden gjordes för alla fallstudier för att undersöka partikelevakuering och luftomsättning i rummet. Flera viktiga parametrar som påverkar detta undersöktes och relevanta förbättringar föreslås i samarbete med industrin. Av resultaten framgår att mängden genererade bakterier i en operationssal kan begränsas genom att minska antalet personer i operationsteamet. Infektionsbenägna operationer skall utföras med så lite personal som möjligt. Den initiala källstyrkan (mängden kolonibildande enheter som en person avger per tidsenhet) från operationsteamet kan avsevärt minskas om högskyddande kläder används. Av resultaten framgår också att ett horisontellt (laminärt) luftflöde kan vara ett bra alternativ till det ofta använda vertikala luftflödet. Ett horisontellt luftflöde är mindre känsligt för termisk påverkan från omgivningen, enkelt att installera och underhålla, relativt kostnadseffektivt och kräver vanligen ingen förändring av befintlig belysningsarmatur. Framför allt begränsar inte denna ventilationsprincip kirurgernas rörelsemönster. De kan luta kroppen över operationsområdet utan att hindra luftflödet. En flyttbar flexibel skärm för horisontell spridning av ultraren ventilationsluft i tillägg till ordinarie ventilation undersöktes också. Man fann att denna typ av tilläggsventilation kan minska antalet luftburna partiklar som bär mikroorganismer om operationspersonalen följer en strikt arbetsordning. Bra samarbete och förståelse mellan ventilationsexperter och operationsteamet på sjukhuset är nyckeln till att få ner infektionsfrekvensen. Det är också viktigt med effektiva och frekventa utvarderingar av bakteriehalten i luften, för såväl nya som befintliga ventilationssystem.
QC 20160129
Slater, Michelle McHugh. "National Inquiry of Clinical Nurse Leadership in the Operating Room". Case Western Reserve University Doctor of Nursing Practice / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=casednp1476639876263273.
Pełny tekst źródłaVasoya, Miteshkumar Mahendrabhai. "Improve Operating Room Utilization through Distributed Scheduling Workflow and Automation". Wright State University / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=wright155917866666766.
Pełny tekst źródłaGutekunst, Kevin Roy. "A REDESIGN OF THE ANESTHESIOLOGIST WORKPLACE IN THE OPERATING ROOM". Thesis, The University of Arizona, 1985. http://hdl.handle.net/10150/275283.
Pełny tekst źródłaAbedini, Amin. "TRADE-OFF BALANCING FOR STABLE AND SUSTAINABLE OPERATING ROOM SCHEDULING". UKnowledge, 2019. https://uknowledge.uky.edu/me_etds/141.
Pełny tekst źródłaAlexander, Sherly Bejoy. "An Effective Succession Planning Educational Program for Operating Room Nurses". ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2950.
Pełny tekst źródłaGunna, Vivek Reddy. "ADAPTIVE MULTI-OBJECTIVE OPERATING ROOM PLANNING WITH STOCHASTIC DEMAND AND CASE TIMES". UKnowledge, 2017. https://uknowledge.uky.edu/me_etds/108.
Pełny tekst źródłaMan, Mei-fun. "A survey of the incidence and causal factors related to occupational back pain in operating theatre nurses in a general acute hospital in Hong Kong /". View the Table of Contents & Abstract, 2005. http://sunzi.lib.hku.hk/hkuto/record/B31384663.
Pełny tekst źródłaTheron, Margot Cecile. "Nursing care practice related to patient safety in the operating room". Thesis, Nelson Mandela Metropolitan University, 2013. http://hdl.handle.net/10948/d1017197.
Pełny tekst źródłaSham, Gregory C. (Gregory Chi-Keung). "Developing a data-driven approach for improving operating room scheduling processes". Thesis, Massachusetts Institute of Technology, 2012. http://hdl.handle.net/1721.1/73397.
Pełny tekst źródłaCataloged from PDF version of thesis.
Includes bibliographical references (p. 52).
In the current healthcare environment, the cost of delivering patient care is an important concern for hospitals. As a result, healthcare organizations are being driven to maximize their existing resources, both in terms of infrastructure and human capital. Using a data-driven approach with analytical techniques from operations management can contribute towards this goal. More specifically, this thesis shows, drawing from a recent project at Beth Israel Deaconess Medical Center (BIDMC), that predictive modeling can be applied to operating room (OR) scheduling in order to effectively increase capacity. By examining the current usage of the existing block schedule system at BIDMC and developing a linear regression model, OR time that is expected to go unused can be instead identified in advance and freed for use. Sample model results show that it is expected to be operationally effective by capturing a large enough portion of OR time for a pooled set of blocks to be useful for advanced scheduling purposes. This analytically determined free time represents an improvement in how the current block system is employed, especially in terms of the nominal block release time. This thesis makes the argument that such a model can integrate into a scheduling system with more efficient and flexible processes, ultimately resulting in more effective usage of existing resources.
by Gregory C. Sham.
S.M.
M.B.A.
Meyer, Rhoda. "Students perceptions of the operating room as a clinical learning environment". Thesis, Stellenbosch : Stellenbosch University, 2014. http://hdl.handle.net/10019.1/95860.
Pełny tekst źródłaENGLISH ABSTRACT: Students undertake their clinical placement in various clinical settings for the exposure to and acquisition of skills related to that particular context. The operating room, for example, is a context that offers the opportunity to develop critical skills related to the perioperative care of the patient. Despite the numerous studies that have been undertaken in this field, few studies that have investigated the operating room as a clinical learning environment in the South African healthcare system have been published. The aim of this study was to determine students’ perceptions of the operating room as a clinical learning environment in a private hospital context. An exploratory, interpretive and descriptive design generating qualitative data was utilized. Data was collected from nursing students undertaking their training at a private nursing education institution. Ten nursing students participated in an open-ended questionnaire (N=10), and twelve students participated in the focus group discussion (N=12). From the results, four themes emerged, namely, ‘interpersonal factors’, ‘educational factors’, ‘private operating room context’, and ‘recommendations’. This study has highlighted some of the challenges experienced by students in the private sector operating room context. Despite the potential learning opportunities, the key findings reveal negative perceptions of students regarding learning experiences. However, the opinion that the operating room offers an opportunity to gain skills unique to this context, as well as facilitates the integration of theory and practice, was also expressed. Some students reported that the emphasis on profitability and cost to patient, and the lack of a mentoring process in this context posed a constraint to learning. Exploration into the specific preparatory needs of students specific to learning outcomes before operating room placement should be considered. It would also be necessary to improve collaboration between lecturers, mentors and theatre managers so that a structured teaching programme may be developed for students entering the perioperative environment.
AFRIKAANSE OPSOMMING: Studente onderneem hul kliniese plasing in verskeie kliniese omgewings vir die blootstelling aan en aanleer van vaardighede wat verband hou met daardie spesifieke konteks. Die operasiesaal, byvoorbeeld, is ’n kliniese omgewing wat die geleentheid bied om kritiese vaardighede te ontwikkel wat verband hou met die perioperatiewe versorging van die pasiënt. Ten spyte van die talle studies wat in die operasiesaal onderneem was, het slegs ’n paar studies uit ’n Suid-Afrikaanse gesondheidsorg oogpunt, die operasiesaal as ’n kliniese opleidings omgewing ondersoek. Die doel van hierdie studie was om studente se persepsies van die operasiesaal as ’n kliniese omgewing in ’n privaat hospitaal konteks te bepaal. ’n Ondersoekende, verklarende en beskrywende ontwerp wat kwalitatiewe data genereer, is gebruik. Data is ingesamel van verpleegstudente wat hul opleiding by ’n privaat verpleegonderrig instelling ontvang. Tien verpleegstudente (N=10) was genooi om ’n onbepaalde vraelys te voltooi en twaalf student (N=12) het aan die fokusgroep bespreking deelgeneem. Vier temas het na vore gekom, naamlik ‘interpersoonlike faktore’, ‘opvoedkundige faktore’, ‘privaat-operasiesaal konteks’, en ‘aanbevelings’. Hierdie studie het ’n paar van die uitdagings uitgelig wat die studente in ’n privaat sektor operasiesaal ondervind. Ten spyte van die potensiële leergeleenthede teenwoordig in die privaat sektor operasiesaal, toon die belangrikste bevindings egter die negatiewe persepsies van studente jeens hierdie kliniese omgewing. Die opinie is egter ook uitgespreek dat hierdie omgewing ook ’n geleentheid aanbied om unieke vaardighede aan te leer. Dit bied ook ’n geleentheid om teorie en praktiese kundigheid te integreer. Sommige studente rapporteer dat die klem op winsgewendheid en koste vir die pasiënt, asoók die gebrek aan mentorskap in hierdie kliniese omgewing ’n beperking plaas op die leerproses. Die spesifieke voorbereidings behoeftes van studente insake leeruitkomste voordat plasing in die operasiesaal omgewing geskied, moet eers deeglik ondersoek word. Dit is ook nodig om die nodige samewerking tussen dosente, mentors en operasiesaal bestuurders te verbeter sodat ’n gestruktureerde onderrig program ontwikkel kan word vir studente wat die perioperatiewe omgewing betree.
Tanaka, Masayuki. "Development of efficiency indicators of operating room management for multi-institutional comparisons". 京都大学 (Kyoto University), 2013. http://hdl.handle.net/2433/175184.
Pełny tekst źródłaHajdukiewicz, John R. "Development of a structured approach for patient monitoring in the operating room". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape17/PQDD_0013/MQ34145.pdf.
Pełny tekst źródłaBrinkman, Mary Adams. "A focused ethnography| Experiences of registered nurses transitioning to the operating room". Thesis, Widener University School of Nursing, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=3570586.
Pełny tekst źródłaThe operating room (OR) is a unique setting and specialty area of nursing practice that requires optimal orientation and education to render safe and efficient patient care. Unfortunately, there will be a significant shortage of nurses in the operating room in the next five to ten years. The need for new nurses in the operating room is essential as many OR nurses in the workforce will retire within the next five years. Currently, most nursing programs no longer offer perioperative courses in their curriculum. Subsequently, this trend has led to the need for hospitals to educate and orient new nurses to their operating rooms. As hospitals educate their own OR nurses, retention following orientation becomes a priority.
The purpose of this study was to explore nurses' experiences as they transition to a new area of nursing practice, the operating room. A qualitative focused ethnography was conducted using Leininger's ethnonursing research method. Fourteen RNs transitioning to the OR agreed to participate in this study. The OR was a first time experience for the RNs. The setting was a large teaching hospital located in an urban area. Observations and interviews were conducted with the RNs to explore their experiences as they transitioned in the OR.
The RNs' transition included learning the didactics of OR nursing through the web-based AORN Nursing 101 online computer course, practicing skills learned in a simulation laboratory, and rotating through surgical specialty areas under the supervision of an RN preceptor. Influences that facilitated the RNs transition to the OR were the
positive learning experience, perception of belonging and acceptance into the OR culture, stimulating environment, supportive personnel, collegiality among peers, and presence of nursing in the OR. Influences that hindered the RNs' transition to the OR were inconsistency in precepting, being in a hostile environment, limited exposure to the OR prior to the RNs' transition, and an overwhelming environment. Meleis' Transition model emerged in the RNs' experiences of transitioning to the OR.
The need to educate nurses in the operating room is essential to assure safety and positive outcomes for the surgical patient. Structured perioperative courses implemented by hospitals or with partnerships with nursing programs can enhance the education, transition, and retention of nurses new to the OR. The importance of a nurse educator having an advanced degree with experience in the OR specialty was essential in coordinating and mentoring nurses transitioning to this new practice area. RNs who are prepared to precept were vital in the education and retention of these RNs. The need for consistent preceptors was recognized as an essential factor to the RNs' successful transition. The findings contribute to evidence-base practice for the design and implementation of perioperative programs for new nurses.
Jay, Rita A. "Relationship of organizational work climate to nurse turnover in operating room settings". Thesis, Capella University, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3724927.
Pełny tekst źródłaOrganizational work climates in healthcare organizations were described in the literature using a social framework of structured interactions, defined roles, and behavioral responses between team members of physicians and nurses. It was hypothesized that the characteristics of physician-nurse collaboration, physician dominance, and nurse autonomy in socially complex work settings have relationships to turnover intent in nurses who work in operating room settings. In an era of nursing shortages the challenge of nurse retention and the evidence of challenging work climate become even more critical for healthcare organizations. This research study examined a gap in knowledge regarding the extent to which aspects of organizational work climate predict nurse turnover in operating room work settings. A quantitative correlational study using three work climate characteristics of physician-nurse collaboration, physician dominance, and nurse autonomy was conducted using the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration (Hojat & Herman, 1985, Developing an Instrument to Measure Attitudes toward Nurses: Preliminary Psychometric Findings) and the Anticipated Turnover Scale (Hinshaw & Atwood, 1983, Nursing Staff Turnover, Stress, and Satisfaction: Models, Measures, and Management). Responses from 322 Operating Room staff nurses who were members of a national professional nursing organization were examined in the analyses. The study concluded that the independent variables of collaboration, dominance, and autonomy were not significant in predicting turnover among nurses in the operating room setting.
Escat, Alexandre. "Conception and development of a preliminary analysis of the operating room performance". Thesis, KTH, Skolan för kemi, bioteknologi och hälsa (CBH), 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-228016.
Pełny tekst źródłaOperationssalens prestation blir mer och mer viktig för sjukhusets ekonomi och patienternas välmående. Därför behöver sjukhusen utveckla instrumentbrädor som kan utvärdera hur denna huvudtjänst presterar, för att sedan kunna bestämma hur man bäst förbättrar den. För att skapa ett sådant hjälpmedel har en litteraturöversikt gjorts för att samla alla relevanta indikatorer från organisationen och dess prestationer. Eftersom endast en bråkdel av dessa behövs så har en grupp med experter sållats ut genom Delphi-metoden; denna bestämde vilka indikatorer som borde behållas respektive avslås, för implementering i hjälpmedlet. Av fyrtiotvå indikatorer kommer endast femton att övervägas och implementeras i grafer. Dessa grafer kommer att skapa den preliminära revision från vilken sjukhus och konsulter kan basera sin prestationsutvärdering av operationssalarna; hjälpmedlet sätter fingret på vad analysen bör fokusera på. Detta hjälpmedel har prövats i ett riktigt sjukhus för att identifiera ett fåtal nödvändiga förbättringar, samt de få tekniska problem som hjälpmedlet hade. Detta hjälpmedel kan spara tid för sjukhus och konsulter. Visserligen skulle man kunna skapa en egen instrumentbräda, noga anpassad till det studerade sjukhuset, men då lär hjälpmedlet inte kunna användas i andra kontexter; man kan också använda ett mer komplext men detaljerat hjälpmedel, men detta kräver mer tid för att förstå hur den bör användas. I sjukvården innebär sparad tid att mer tid kan läggas på patienterna, vilket i slutändan förbättrar deras upplevelser och välmående. Dessutom kommer detta hjälpmedel, i jämförelse med enkla instrumentbrädor, att bidra med mer användbara indikatorer och hjälpa sjukhusets ledning att ta somliga beslut och omvärdera andra – än en gång för patienternas bästa.
Navabi-Shirazi, Mohammad Jafar. "Integration of operating room monitors for development of a smart alarm system". Diss., The University of Arizona, 1990. http://hdl.handle.net/10150/185184.
Pełny tekst źródłaCosgrove, Marianne S. "PERCEIVED IMPACT OF AMBIENT OPERATING ROOM NOISE BY CERTIFIED REGISTERED NURSE ANESTHETISTS". VCU Scholars Compass, 2019. https://scholarscompass.vcu.edu/etd/5963.
Pełny tekst źródłaBoson, Maria, i Linda Smedman. "Operationssjuksköterskans upplevelse av sin yrkesroll : -en kvalitativ intervjustudie". Thesis, Mittuniversitetet, Institutionen för hälsovetenskap, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-13527.
Pełny tekst źródłaBackground The profession of operating room nurse is now the oldest nursing specialty, but remains primarily a hidden profession because it is exercised behind closed doors. The professional role were described as complex and revolved around the patient, cooperation and the technical equipment. Patricia Benners theories on the nurses’ professional development were used as a theoretical basis in the study. Aim The study aimed to elucidate how the operating room nurse perceives the professional role. Method The study was conducted with a qualitative approach and ten semi-structured interviews were carried out with operating room nurses from two hospitals in Sweden in spring 2011. All interviews were recorded and transcribed verbatim. To analyze the collected data content analysis with an inductive approach was used. Result In the text analysis twelve subcategories and four categories were identified: the role as being responsible of nursing, the experience of what makes the operating room nurse safe in the professional role, the meaning of being a co-worker during the work on the operating room and the view on the own profession Quotes from the informants were presented in the text to clarify the result. Conclusion The study showed that the operating room nurse has a central role for nursing in the surgical ward and the patient. The operating room nurse presence and expertise in operations was irreplaceable, but always dependent of the team around him/her.
Richardson-Tench, Marilyn 1947. "Unmasked! : the discursive practice of the operating room nurse : a Foucauldian feminist analysis". Monash University, Faculty of Education, 2001. http://arrow.monash.edu.au/hdl/1959.1/8900.
Pełny tekst źródłaZheng, Liying. "Operating Room Version of Safety Attitudes Questionnaire – An Analysis Using Structural Equation Models". Thesis, Uppsala universitet, Statistiska institutionen, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-175920.
Pełny tekst źródłaSiegel, Hugh Andrew. "Subjectivity Of Estimating Blood Loss Among Health Care Providers In The Operating Room". VCU Scholars Compass, 1993. https://scholarscompass.vcu.edu/etd/5263.
Pełny tekst źródłaКотенко, М. М. "Оцінка ефективності роботи операційного залу ВАТ "Ощадбанк" за допомогою СМО типу M|M|N|". Thesis, Видавництво СумДУ, 2010. http://essuir.sumdu.edu.ua/handle/123456789/4289.
Pełny tekst źródłaHilton, George Leslie. "SENSORY REGRESSION TIME FROM SUBARACHNOID BLOCK WITH HYPERBARIC 0.75% BUPIVACAINE IN THE OBESE PATIENT". VCU Scholars Compass, 1989. http://scholarscompass.vcu.edu/etd/5067.
Pełny tekst źródłaHudalla, Christa Choate. "The Effect of Tourniquet Application On Systemic Coagulation". VCU Scholars Compass, 1992. http://scholarscompass.vcu.edu/etd/5073.
Pełny tekst źródłaOsborne, Sonya Ranee, i n/a. "Compliance with standard precautions and occupational exposure reporting among operating room nurses in Australia". University of Canberra. Nursing, 2002. http://erl.canberra.edu.au./public/adt-AUC20060823.161225.
Pełny tekst źródłaKavanaugh, Irenaanna. "A Phenomenological Study of How Leadership Efficacy Affects the Culture of Operating Room Safety". Thesis, Northcentral University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10634329.
Pełny tekst źródłaPatient safety remains a global challenge that has required constant resolve to improve personnel skills, responsiveness to detail, and transformational actions. This phenomenological study explored how an operating room?s culture of patient safety was affected by the efficacy of its leadership in managing its critical qualitative safety characteristics. Despite the current technological advances and various patient safety measures, studies have reported not only an increasing number of preventable sentinel events, but also recurring mistakes that continue to cause death or serious health complications. There have been numerous administrative attempts to improve the culture of safety in the operating room using performance evaluations, check off sheets, patient satisfaction surveys, and educational seminars. However, the number of patient safety infractions continues to increase. There has not been a model that investigated how leadership efficacy affected an operating room?s culture of patient safety. The paradigm applied in this study established the relevance that leadership efficacy could have in strengthening the operating room?s culture of safety. The hermeneutic-styled, phenomenological case study examined the operating room personnel?s perception of the operating room?s leadership efficacy, and how the personnel?s perceptions of the quality safety characteristics affected the culture of patient safety. The study implemented a non-probability, non-random sample that consisted of 18 skilled surgical personnel of a Level II Trauma Center facility located in Central Florida. The study employed a phenomenological methodology of collection and hermeneutic dissection of interview data. Analysis revealed several findings that established a positive link between each of the qualitative safety characteristics, the qualities of effective leadership, and a progressive culture of patient safety. Future studies could be expanded to include operating room personnel from multiple facilities of the same health organization, and operating room personnel from multiple facilities of multiple health organizations.