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Khatibi, Toktam, Sepehri, Mohammad Mehdi, Shadpour, Pejman, Zegordi, Seyed Hesameddin. (1394). Prioritizing interrupt causes in minimally-invasive surgeries based on identifying causal relations between interrupt causes. , 49(1), 33-43. doi: 10.22059/jieng.2015.54139
Toktam Khatibi; Mohammad Mehdi Sepehri; Pejman Shadpour; Seyed Hesameddin Zegordi. "Prioritizing interrupt causes in minimally-invasive surgeries based on identifying causal relations between interrupt causes". , 49, 1, 1394, 33-43. doi: 10.22059/jieng.2015.54139
Khatibi, Toktam, Sepehri, Mohammad Mehdi, Shadpour, Pejman, Zegordi, Seyed Hesameddin. (1394). 'Prioritizing interrupt causes in minimally-invasive surgeries based on identifying causal relations between interrupt causes', , 49(1), pp. 33-43. doi: 10.22059/jieng.2015.54139
Khatibi, Toktam, Sepehri, Mohammad Mehdi, Shadpour, Pejman, Zegordi, Seyed Hesameddin. Prioritizing interrupt causes in minimally-invasive surgeries based on identifying causal relations between interrupt causes. , 1394; 49(1): 33-43. doi: 10.22059/jieng.2015.54139

Prioritizing interrupt causes in minimally-invasive surgeries based on identifying causal relations between interrupt causes

Advances in Industrial Engineering
مقاله 4، دوره 49، شماره 1، تیر 2015، صفحه 33-43    اصل مقاله (668.97 K)
نوع مقاله: Research Paper
شناسه دیجیتال (DOI): 10.22059/jieng.2015.54139
نویسندگان
Toktam Khatibi1؛ Mohammad Mehdi Sepehri* 1؛ Pejman Shadpour2؛ Seyed Hesameddin Zegordi1
1Department of Industrial Engineering, Tarbiat Modares University, Tehran, I.R. Iran
2Hospital Management Research Center, Tehran University of Medical Sciences, Tehran, I.R. Iran
چکیده
Laparoscopy or minimally-invasive surgery is a surgical technique in which the surgical operations are performed via a few small incisions. This kind of surgery has fewer complications over open surgery. Finding methods for shortening the time of laparoscopic surgeries can improve operating room efficiency. An approach to shortening the time of laparoscopic surgeries is identifying the interruptions in these surgeries and preventing from their occurrence or reducing the potential of occurrence of the identified interrupt causes. In this paper, the interrupt causes of laparoscopic surgeries are prioritized based on the identified causal relations between interrupt causes.
Research population is the laparoscopic surgeries performed in Hasheminezhad kidney center in May-June 2013. For this purpose, 25 laparoscopic surgeries are observed in this hospital in this time interval. Causal relations among interrupt causes are identified from the gathered data. The main causes are identified and ranked based on Fuzzy TOPSIS method. For prioritizing the interrupt causes, frequency of occurrence, average length, severity degree, the potential of reducing interrupt occurrence and the potential of preventing interrupt occurrence are considered.
Experimental results show that the most important interrupt causes in laparoscopic surgeries are staff shortage or multi-tasking staff, foggy lens, unavailable surgical instruments, dirty lens and finally low-experienced staff. Moreover, sensitivity analysis on criteria weighting show that the mentioned interrupt causes are the five most-important interrupt causes in more than 80% of the evaluated scenarios.
Preventing the occurrence of the most-important interrupt causes can improve the surgical time. If it is not possible, reducing the average length of interrupts caused by the identified main causes can be considered for improvement of the operating room efficiency.
کلیدواژه‌ها
time interruptions؛ laparoscopic surgeries؛ causal relations؛ multi attribute decision making
عنوان مقاله [English]
اولویت‏ بندی علل وقفة جراحی لاپاراسکوپی بر پایة شناسایی روابط علّی
نویسندگان [English]
توکتم خطیبی1؛ محمد مهدی سپهری1؛ پژمان شادپور2؛ سید حسام‌الدین ذگردی1
1دکتری مهندسی صنایع بخش مهندسی صنایع دانشکدة فنی و مهندسی دانشگاه تربیت مدرس
2دانشیار و دکتری پزشکی (فوق تخصصی اورولوژی) مرکز تحقیقات مدیریت بیمارستانی دانشگاه علوم پزشکی ایران
چکیده [English]
جراحی لاپاراسکوپی یا کم‏تهاجمی نوعی عمل جراحی است که در آن شکاف‏هایی کوچک و اندک بر بدن بیمار ایجاد می‌شود. این نوع جراحی نسبت به جراحی‏های باز، در موارد مشابه، عوارض کمتری دارد. کوتاه‏شدن زمان جراحی لاپاراسکوپی می‌تواند منافع بسیاری داشته باشد؛ از جمله کاهش هزینه‌ها، افزایش بهره‌وری منابع، و افزایش کارایی پرسنل. یکی از روش‌های کوتاه‌کردن زمان جراحی لاپاراسکوپی شناسایی علل بروز وقفه و جلوگیری از وقوع آن یا کاهش احتمال وقوع آن است. از این رو، هدف این مطالعه شناسایی و رتبه‌بندی علل بروز وقفه در جراحی لاپاراسکوپی بر اساس شناسایی روابط علّی میان این علت‏ها بود. جامعة پژوهش متشکل از بیست و پنج عمل جراحی لاپاراسکوپی اورولوژی انجام‌شده در بیمارستان شهید هاشمی‌نژاد تهران در خردادماه 1392 بود. نتایج نشان داد مهم‌ترین علل بروز وقفه در جراحی لاپاراسکوپی به ترتیب شامل کمبود یا چندوظیفه‌ای‌بودن پرسنل، غبارآلودشدن لنز، دردسترس‌نبودن ابزارآلات، آغشته‌شدن لنز به خون یا سایر مواد، و بی‏تجربگی پرسنل است. از سوی دیگر نتایج تحلیل حساسیت وزن‏های شاخص‏ها نشان داد در بیش از 80 درصد سناریوهای بررسی‌شده پنج علت مزبور به منزلة پنج علت برتر ایجاد وقفه در جراحی لاپاراسکوپی شناخته شده‏اند. با به‌کارگیری نتایج این پژوهش می‏توان بهره‏وری اتاق عمل را در این‌گونه عمل‏های جراحی افزایش داد.
کلیدواژه‌ها [English]
تصمیم‌گیری چندشاخصه, جراحی لاپاراسکوپی, روابط علّی, وقفة زمانی
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