Study finds overlapping surgeries to be safe
ROCHESTER, Minn., USA: “Overlapping surgeries”, a common way to schedule surgeries to expand a patient’s access to care and improve hospital efficiency, is as safe and provides the same outcomes for patients as non-overlapping surgeries do, a new study has found. The research was conducted by Mayo Clinic, a non-profit organization committed to clinical practice, education and research, providing expert, whole-person care to everyone who needs healing.
Spacing operations, where a surgeon has two patients in operating rooms at the same time, is already common practice in surgery at Mayo and other leading medical institutions. It gives patients greater access to qualified surgeons, allows more efficient use of operating rooms and avoids unnecessary downtime for surgeons. The Mayo Clinic’s study compared the outcomes of thousands of such overlapping surgeries with non-overlapping operations at its Rochester campus and found no difference in the rates of postoperative complications or deaths between the two groups of patients, within a month after surgery.
The researchers used Mayo Clinic data from the University HealthSystem Consortium, an alliance of academic medical centers whose members include Mayo Clinic, to match 10,614 overlapping surgeries to 16,111 non-overlapping procedures performed at the Mayo’s Rochester campus. An additional sample, using more than 10,000 operations including over 3,000 with overlap, matched by surgeon, was analyzed using data from the Rochester campus in the American College of Surgeons National Surgical Quality Improvement Program. The additional sample also showed no differences between overlapping or non-overlapping surgeries in its outcomes.
“Our data shows that overlapping surgery, as practiced here, is safe,” says co-author Dr. Robert Cima, a colorectal surgeon and chair of surgical quality at Mayo Clinic's Rochester campus. “We think it provides value to our patients, because it allows more patients timely access to surgery and care by expert teams.”
In medical parlance, overlapping surgery differs from concurrent surgery. In overlapping surgeries, operations are staggered in a way that the key parts of the procedure, called the “critical portions”, do not occur at the same time. In this way, the surgeon is present for the critical portions of each operation and is available immediately for non-critical portions, such as closing the wound. In concurrent surgery, a surgeon also has two patients in operating rooms at the same time, but the critical portions of the surgeries overlap. Concurrent surgery is rare and is not allowed by Medicare.
Mayo Clinic has continuously studied its surgical outcomes to improve the quality of the procedures, refine operating room scheduling and other surgical systems and procedures to improve the patient’s experience, the patient’s access to high-quality care and hospital efficiency. Key findings over the years include the importance of scheduling surgeries early in the day when possible, rather than at night, when data shows complications are more likely. Planning cases to overlap during the day also helps avoid unnecessary night surgeries. Teams with multiple surgeons are common at Mayo, which has the skill and surgical infrastructure to perform complex operations that involve two or more surgical specialties. These cases may also overlap to make surgeons available when they are needed for multi-surgeon procedures.
The findings of the study are published in the Annals of Surgery .