naa a22 4500 510744745 CHVBK 20180411083041.0 cr unu---uuuuu 180411e20131101xx s 000 0 eng 10.1007/s12630-013-0025-5 doi (NATIONALLICENCE)springer-10.1007/s12630-013-0025-5 Cohort study of cases with prolonged tracheal extubation times to examine the relationship with duration of workday [Elektronische Daten] [Richard Epstein, Franklin Dexter, Sorin Brull] Étude de cohorte des cas d'extubation trachéale prolongée pour étudier leur relation avec la durée des journées de travail Purpose: The economics of the use of an anesthetic drug or device that produces benefit through reduction in operating room (OR) time depends on the day of the week and the total hours of surgical cases in the OR in which they are performed. Principally, this has to do with different durations of the regularly scheduled workday in the ORs within and among hospitals. We tested hypotheses relevant to the economic benefit of avoiding prolonged tracheal extubation times. Methods: Observational data were obtained from a multiple-specialty academic tertiary hospital that uses an anesthesia information management system. Prolonged tracheal extubation times were considered those with tracheal extubations occurring 15min or more after the end of surgery. The assessment of prolonged tracheal extubation times was limited to cases for which the patient's trachea was intubated and extubated while physically in the OR. Percentages were calculated for each of n=39 four-week periods. Results are reported as mean (standard error of the mean) of these percentages, and the phrases "at most/least” are used to refer to the corresponding 95% confidence limits. Results: At most, 6.1% [mean 5.5 (0.3)%] of the prolonged tracheal extubation times were attributable to cases that did not end during regular workdays from 7:00 AM-10:59 PM. At least 55.6% of prolonged tracheal extubation times occurred during cases on regular workdays and in an OR with more than eight hours of cases and turnovers [mean 57.0 (0.9)%; P<0.0001]. This percentage was 23.8 (0.8)% larger than for all other cases. Conclusions: In the absence of an accurate facility-specific cost analysis, prolonged tracheal extubation times should not be treated as fixed costs but as resulting in proportionally increased OR variable costs. Canadian Anesthesiologists' Society, 2013 Epstein Richard Department of Anesthesiology, Jefferson Medical College, Philadelphia, PA, USA aut Dexter Franklin Division of Management Consulting, Department of Anesthesia, University of Iowa, 200 Hawkins Drive, 6JCP, 52242, Iowa City, IA, USA aut Brull Sorin Department of Anesthesiology, Mayo Clinic College of Medicine, Jacksonville, FL, USA aut Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer US; http://www.springer-ny.com 60/11(2013-11-01), 1070-1076 0832-610X 60:11<1070 2013 60 12630 https://doi.org/10.1007/s12630-013-0025-5 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12630-013-0025-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Epstein Richard Department of Anesthesiology, Jefferson Medical College, Philadelphia, PA, USA aut NATIONALLICENCE 700 1- Dexter Franklin Division of Management Consulting, Department of Anesthesia, University of Iowa, 200 Hawkins Drive, 6JCP, 52242, Iowa City, IA, USA aut NATIONALLICENCE 700 1- Brull Sorin Department of Anesthesiology, Mayo Clinic College of Medicine, Jacksonville, FL, USA aut NATIONALLICENCE 773 0- Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer US; http://www.springer-ny.com 60/11(2013-11-01), 1070-1076 0832-610X 60:11<1070 2013 60 12630 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer