Modeling and prediction of surgical procedure times

Accurate prediction of medical operation times is of crucial importance for cost efficient operation room planning in hospitals. This paper investigates the possible dependence of procedure times on surgeon factors like age, experience, gender, and team composition. The effect of these factors is estimated for over 30 different types of medical operations in two hospitals, by means of ANOVA models for logarithmic case durations. The estimation data set contains about 30,000 observations from 2005 till 2008. The relevance of surgeon factors depends on the type of operation. The factors found most often to be significant are team composition, experience, and daytime. Contrary to widespread opinions among surgeons, gender has nearly never a significant effect. By incorporating surgeon factors, the accuracy of out-of-sample prediction of case durations of about 1,250 surgical operations in 2009 is improved by up to more than 15 percent as compared to current planning procedures.planning;ANOVA model;European hospital;current procedure terminology (CPT);health care management;lognormal distribution;operation room;surgeon factors

Medical Response, Search and Recovery during the Space Shuttle Columbia Accident Investigation

On February 1, 2003, the Space Shuttle Columbia broke apart during atmospheric re-entry on mission STS-107. After an event such as this, with high visibility and international interest, the operational challenge of recovering the crewmembers could not be underestimated. The Space Shuttle Program is organized to respond to a vehicle mishap using the resources of the Mishap Investigation Team (MIT). On the afternoon of Feb. 1, 2003, the MIT deployed to Barksdale Air Force Base (AFB), Louisiana. This location became the investigative center and interim storage location for crewmembers received from the Lufkin, Texas Disaster Field Office (DFO). The Lufkin DFO served as the primary area for all operations, including staging assets and deploying field teams for search, recovery and security of crewmember remains. More than 2,000 people from numerous organizations were involved with the recovery of the crew. All seven crewmembers of STS-107 were recovered and ceremonial last rights were administered. Astronaut and military personnel escorted the crew with honor to the MIT at Barksdale AFB, Louisiana. At Barksdale AFB a temporary morgue was established in an aircraft hangar and operated for approximately two weeks during which time coordination with the DFO field recovery teams, Armed Forces Institute of Pathology (AFIP) medical personnel, and the crew surgeons was on going. Families of crewmembers and NASA management were notified daily of the current findings. Working under the leadership of the MIT Lead, the medical team developed and executed a short-term plan to identify and relocate the crew with a military honor guard and protocol to the medical examiner at the Armed Forces Port Mortuary, Dover AFB, Delaware. After operations at Barksdale AFB were concluded the medical team transitioned back to Houston and a long-term plan was developed and implemented which involved the Air Force Mortuary Affairs at Randolph AFB, Texas. This plan was coordinated with search teams in the field, Barksdale AFB Mortuary Affairs, KSC security, AFIP, and the crew surgeons at JSC

John Glenn's Return to Flight - Flight Surgeons Perspective

No abstract availabl

Loss of Signal, Aeromedical Lessons Learned from the STS-107 Columbia Space Shuttle Mishap

Loss of Signal, a NASA publication to be available in May 2014 presents the aeromedical lessons learned from the Columbia accident that will enhance crew safety and survival on human space flight missions. These lessons were presented to limited audiences at three separate Aerospace Medical Association (AsMA) conferences: in 2004 in Anchorage, Alaska, on the causes of the accident; in 2005 in Kansas City, Missouri, on the response, recovery, and identification aspects of the investigation; and in 2011, again in Anchorage, Alaska, on future implications for human space flight. As we embark on the development of new spacefaring vehicles through both government and commercial efforts, the NASA Johnson Space Center Human Health and Performance Directorate is continuing to make this information available to a wider audience engaged in the design and development of future space vehicles. Loss of Signal summarizes and consolidates the aeromedical impacts of the Columbia mishap process-the response, recovery, identification, investigative studies, medical and legal forensic analysis, and future preparation that are needed to respond to spacecraft mishaps. The goal of this book is to provide an account of the aeromedical aspects of the Columbia accident and the investigation that followed, and to encourage aerospace medical specialists to continue to capture information, learn from it, and improve procedures and spacecraft designs for the safety of future crews. This poster presents an outline of Loss of Signal contents and highlights from each of five sections - the mission and mishap, the response, the investigation, the analysis and the future

Humans in Space: Summarizing the Medico-Biological Results of the Space Shuttle Program

As we celebrate the 50th anniversary of Gagarin's flight that opened the era of Humans in Space we also commemorate the 30th anniversary of the Space Shuttle Program (SSP) which was triumphantly completed by the flight of STS-135 on July 21, 2011. These were great milestones in the history of Human Space Exploration. Many important questions regarding the ability of humans to adapt and function in space were answered for the past 50 years and many lessons have been learned. Significant contribution to answering these questions was made by the SSP. To ensure the availability of the Shuttle Program experiences to the international space community NASA has made a decision to summarize the medico-biological results of the SSP in a fundamental edition that is scheduled to be completed by the end of 2011 beginning 2012. The goal of this edition is to define the normal responses of the major physiological systems to short-duration space flights and provide a comprehensive source of information for planning, ensuring successful operational activities and for management of potential medical problems that might arise during future long-term space missions. The book includes the following sections: 1. History of Shuttle Biomedical Research and Operations; 2. Medical Operations Overview Systems, Monitoring, and Care; 3. Biomedical Research Overview; 4. System-specific Adaptations/Responses, Issues, and Countermeasures; 5. Multisystem Issues and Countermeasures. In addition, selected operational documents will be presented in the appendices. The chapters are written by well-recognized experts in appropriate fields, peer reviewed, and edited by physicians and scientists with extensive expertise in space medical operations and space-related biomedical research. As Space Exploration continues the major question whether humans are capable of adapting to long term presence and adequate functioning in space habitats remains to be answered We expect that the comprehensive review of the medico-biological results of the SSP along with the data collected during the missions on the space stations (Mir and ISS) provides a good starting point in seeking the answer to this question

Medical Response/Search/Recovery and Lessons Learned from the Space Shuttle Columbia Accident Investigation

No abstract availabl

Loss of Signal, Aeromedical Lessons Learned for the STS-I07 Columbia Space Shuttle Mishap

Loss of Signal, a NASA publication to be available in May 2014, presents the aeromedical lessons learned from the Columbia accident that will enhance crew safety and survival on human space flight missions. These lessons were presented to limited audiences at three separate Aerospace Medical Association (AsMA) conferences: in 2004 in Anchorage, Alaska, on the causes of the accident; in 2005 in Kansas City, Missouri, on the response, recovery, and identification aspects of the investigation; and in 2011, again in Anchorage, Alaska, on future implications for human space flight. As we embark on the development of new spacefaring vehicles through both government and commercial efforts, the NASA Johnson Space Center Human Health and Performance Directorate is continuing to make this information available to a wider audience engaged in the design and development of future space vehicles. Loss of Signal summarizes and consolidates the aeromedical impacts of the Columbia mishap process-the response, recovery, identification, investigative studies, medical and legal forensic analysis, and future preparation that are needed to respond to spacecraft mishaps. The goals of this book are to provide an account of the aeromedical aspects of the Columbia accident and the investigation that followed, and to encourage aerospace medical specialists to continue to capture information, learn from it, and improve procedures and spacecraft designs for the safety of future crews

Modeling and prediction of surgical procedure times

Accurate prediction of medical operation times is of crucial importance for cost efficient operation room planning in hospitals. This paper investigates the possible dependence of procedure times on surgeon factors like age, experience, gender, and team composition. The effect of these factors is estimated for over 30 different types of medical operations in two hospitals, by means of ANOVA models for logarithmic case durations. The estimation data set contains about 30,000 observations from 2005 till 2008. The relevance of surgeon factors depends on the type of operation. The factors found most often to be significant are team composition, experience, and daytime. Contrary to widespread opinions among surgeons, gender has nearly never a significant effect. By incorporating surgeon factors, the accuracy of out-of-sample prediction of case durations of about 1,250 surgical operations in 2009 is improved by up to more than 15 percent as compared to current planning procedures

Loss of Signal: Aeromedical Lessons Learned from the STS-107 Columbia Space Shuttle Mishap

The editors of Loss of Signal wanted to document the aeromedical lessons learned from the Space Shuttle Columbia mishap. The book is intended to be an accurate and easily understood account of the entire process of recovering and analyzing the human remains, investigating and analyzing what happened to the crew, and using the resulting information to recommend ways to prevent mishaps and provide better protection to crewmembers. Our goal is to capture the passions of those who devoted their energies in responding to the Columbia mishap. We have reunited authors who were directly involved in each of these aspects. These authors tell the story of their efforts related to the Columbia mishap from their point of view. They give the reader an honest description of their responsibilities and share their challenges, their experiences, and their lessons learned on how to enhance crew safety and survival, and how to be prepared to support space mishap investigations. As a result of this approach, a few of the chapters have some redundancy of information and authors' opinions may differ. In no way did we or they intend to assign blame or criticize anyone's professional efforts. All those involved did their best to obtain the truth in the situations to which they were assigned

Operational and Medical Procedures for a Declared Contingency Shuttle (CSCS) Shuttle Mission Due to a Failure that Precludes a Safe Return

This poster paper outlines the operational and medical procedures for a shuttle mission that has a failure that precludes a safe return to Earth. Information about the assumptions, procedures and limiting consumables is included