A Novel Checklist Approach to Reduce Time Under Anesthesia in Neurosurgery.

Abstract

Neurosurgical procedures require meticulous preparation, including extra measures to ensure patient safety and the appropriate setup of the operating room, which must be fully established before the surgeon can initiate the first incision. Neurosurgical delay encompasses the time from anesthesia induction start to when the neurosurgeon makes the first incision. 30 neurosurgery procedures were observed randomly. Data were collected at 4 specific time intervals related to the process of 30 neurosurgery procedures in an operating room. 30 random observations show the bottleneck being anesthesia induction complete to the surgeon's first cut which accounts for 50% of times more than the average time (mean 33 minutes, n = 30). Minimizing the duration of anesthesia from anesthesia induction complete to surgeon first cut reduces risks, improves patient care and patient satisfaction, ensures a seamless flow of activities, and minimizes the variability in neurosurgical operating time. Operational neurosurgical delays can be improved using sequential checklists by constraining the variability in each phase. The article provides a conceptual novel checklist that provides a modular approach and completion of all steps in a phase reduces the variability of error to the next phase. This approach eventually reduces the patient's time under anesthesia.