The practice of overlapping surgeries is not only safe but may even be beneficial to neurosurgery patients, according to findings presented at the American Association of Neurological Surgeons 2018 Annual Meeting in New Orleans and detailed in Medscape.
Here are six things to know.
1. Overlapping surgery occurs when one surgeon runs more than one operating room simultaneously; the critical portions of the surgery do not overlap. According to William Couldwell, MD, professor and chair of neurosurgery at the University of Utah in Salt Lake City, it has become commonplace in academic medical centers to increase access to care, enhance resident training and promote efficient OR use.
2. Anthony DiGiorgio, DO, a sixth-year neurosurgery resident at New Orleans-based Louisiana State University Health, reported the findings from a study of neurosurgery patients treated before and after overlapping was allowed.
3. The study was conducted across a seventh-month period at the LSU interim safety net hospital that replaced Charity Hospital after Hurricane Katrina. The OR schedule was covered by one neurosurgeon, one chief resident, one lower-level resident and no mid-level providers. Approximately three quarters of cases were spine surgeries.
4. During the period in which overlapping was allowed, elective neurosurgery case volume increased from 98 to 141 cases. Urgent cases increased from 59 to 63 and emergent from 44 to 47 cases.
5. The surgical complications and 30-day readmission rates were equivalent between overlapping surgery and single-room use. The practice also trended toward a $50,000 savings in hospital charges
6. The average overlapping neurosurgery patient went to surgery about two days faster than single-room use. While this trend did not reach statistical significance, the two-day reduction in wait time for surgery led to a significant six-day reduction in length of stay.
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