A Retrospective Study of Operating Room Utilization and Efficiency in a Pediatric Dental Residency Program

Purpose: The purpose was to assess and understand operating room (OR) utilization and efficiency in a pediatric dental residency program. Methods: A retrospective study was performed using chart extraction from 778 patients completed by both pediatric dentistry faculty (n=7) and residents (n=17) in an ambulatory care setting over a 32 month period (between July 2010 and March 2013). Patterns in OR usage time were determined by documenting various timing metrics (start and stop times for anesthesia, start and stop times for the dental procedure, times for throat pack in and out), noting patient information (age and ASA patient classification status), and creating variables by grouping data by clinical provider type and dental procedure. OR usage time was analyzed using multiple regression to estimate the per-tooth or per-mouth time for each type of procedure. Results: The median procedure time was 75 minutes (range= 1 to 517 minutes). Multiple regression indicated that for the average patient, a faculty member took 63.8 minutes (95% CI = 60.8 to 66.7 minutes) and a resident took 81.9 minutes (95% CI = 78.7 to 85.0 minutes, P\u3c.0001).These results demonstrate that the appropriate scheduling of operating room should be based on the proficiency level of provider as well as the complexity of the dental procedure. Conclusion: This study concludes that pediatric dental operating room planning and scheduling in teaching hospitals should take into account real constraints such as residents’ level of training and skill

Left Out in the Cold: The Problem with Aboriginal Title under Section 35(1) of the Constitution Act, 1982 for Historically Nomadic Aboriginal Peoples

In R. v. Adams and Delgamuukw v. British Columbia, the Supreme Court of Canada made statements to the effect that certain historically nomadic Aboriginal groups may be unable to make out a claim for Aboriginal title under section 35(1) of the Constitution Act, 1982. In light of the anthropological evidence relating to the close connection some of these groups enjoyed with the lands they occupied, a serious injustice may arise if these groups are indeed barred from an Aboriginal title claim. The author attempts to correct this potential injustice by demonstrating that at least some of these historically nomadic groups could meet the exclusive occupation test for Aboriginal title developed in Delgamuukw. As an alternative solution, the author proposes an additional test to facilitate proof of Aboriginal title for deserving historically nomadic groups that might otherwise be precluded from claiming such title