Impact of a more restrictive overlapping surgery policy: an analysis of pre- and postimplementation complication rates, resident involvement, and surgical wait times at a high-volume neurosurgical department

Journal of Neurosurgery
Jian GuanRichard H Schmidt

Abstract

OBJECTIVE Recently, overlapping surgery has been a source of controversy both in the popular press and within the academic medical community. There have been no studies examining the possible effects of more stringent overlapping surgery restrictions. At the authors' institution, a new policy was implemented that restricts attending surgeons from starting a second case until all critical portions of the first case that could require the attending surgeon's involvement are completed. The authors examined the impact of this policy on complication rates, neurosurgical resident education, and wait times for neurosurgical procedures. METHODS The authors performed a retrospective chart review of nonemergency neurosurgical procedures performed over two periods-from June 1, 2014, to October 31, 2014 (pre-policy change) and from June 1, 2016, to October 31, 2016 (post-policy change)-by any of 4 senior neurosurgeons at a single institution who were authorized to schedule overlapping cases. Information on preoperative evaluation, patient demographics, premorbid conditions, surgical variables, and postoperative course were collected and analyzed. RESULTS Six hundred fifty-three patients met inclusion criteria for complications analysis. Of...Continue Reading

References

Sep 19, 1980·Science·J Abelson
Jun 28, 2011·World Neurosurgery·Federico Alfonso Landriel IbañezAntonio Carrizo
Mar 18, 2016·JAMA : the Journal of the American Medical Association·Michelle M Mello, Edward H Livingston
Mar 18, 2016·JAMA Surgery·Alexander Langerman
Nov 18, 2016·The Journal of Bone and Joint Surgery. American Volume·Alan L ZhangBrian T Feeley
Dec 7, 2016·Annals of Surgery·Joseph A HyderElizabeth B Habermann

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Citations

Mar 14, 2019·Proceedings of the National Academy of Sciences of the United States of America·Dimitris BertsimasSebastien Martin
Feb 15, 2020·The Journal of Bone and Joint Surgery. American Volume·Gregory GlauserNeil R Malhotra
Nov 25, 2020·Urology·Reza NabavizadehKenneth Ogan
Feb 8, 2021·Urology·Reza NabavizadehKenneth Ogan
Mar 7, 2021·The Spine Journal : Official Journal of the North American Spine Society·Andrew KimRaymond Hah
May 11, 2021·The Journal of Law, Medicine & Ethics : a Journal of the American Society of Law, Medicine & Ethics·Margaret B MitchellAlexander Langerman
Feb 6, 2020·The Journal of Thoracic and Cardiovascular Surgery·Gregory GlauserNeil R Malhotra

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