Impact of dedicated surgical technologist on the efficiency of shoulder arthroplasty operating rooms

The purpose of this study is to evaluate the efficiency of primary shoulder arthroplasty cases including anatomic (ATSA) and reverse shoulder arthroplasty (RTSA) and OR turnover time in cases performed by a sports medicine orthopedic surgeon at a highvolume academic center after hiring a surgical technologist dedicated to OR efficiency/turnover. Cases were collected across a 18 month period prior to hiring this technologist and a 15 month period after the hire. There was a 3 month “wash-out” period between these two periods for training. The primary outcome measuresanalyzed include: (1) Surgical time (ST) defined by the start time from skin incision to the end of dressing application; (2) Wheels-Out to Room Ready defined by the time of the patient leaving the OR to the time that the OR is ready for the next patient; (3) Room ready time for the start of the first case of the day defined as the scheduled 7:30 AM start time; and (4) Turnover Time (TOT) defined by Wheels-Out to Wheels-In. The mean absolute surgical time for RTSA showed a decrease of 14 minutes after the arrival of the dedicated surgical technologist (P < 0.00031). All arthroplasty cases in the series showed a decrease of 8.9 minutes in with the dedicated surgical technologist (P < 0.032). Mean room ready time showed a decrease of 5 minutes (P < 0.000014). With ATSA, there was not a statistically significant difference for AST (P = 0. 0.495). TOT showed a decrease of 7.2 minutes in mean and 16.5 minutes in median (P = 0.0000140). The findings provide an evidence-based framework for evaluating the advantages of including a dedicated surgical technologist as a supplement to the OR team.