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https://www.selleckchem.com/products/ly333531.html Objective Lean management strategies aim to increase efficiency by eliminating waste or by improving processes to optimize value. The operating room (OR) is an arena where these strategies can be implemented. We assessed changes in OR efficiency after the application of lean methodology on perioperative anesthesia associated with posterior cervical spine surgeries. Methods We utilized pre- and post-lean study design to identify inefficiencies during the perioperative anesthesia process and implemented strategies to improve the process. Patient characteristics were recorded to assess for differences between the two groups [Group 1 (pre-lean) and Group 2 (post-lean)]. In the pre-lean period, key steps in the perioperative anesthesia process were identified that were amenable to lean implementation. The time required for each identified key step was recorded by an independent study coordinator. The times for each step were then compared between the groups utilizing univariate analyses. Results After lean implementation, there was a significant decrease in overall perioperative anesthesia process time (88.4±4.7 vs. 76.2±3.2 min, p=0.04). This was driven by significant decreases in the steps transport and setup (10.4±0.8 vs. 8.0±0.7 min, p= 0.03) and positioning (20.8±2.1 vs. 15.7±1.3 min, p= 0.046). Of note, the total time spent in the operating room was lower for Group 2 (270.1±14.6 vs. 252.8±14.1 min) but the result was not statistically significant, even when adjusting for number of operated levels. Conclusion Lean methodology may be successfully applied to posterior cervical spine surgery whereby improvements in the perioperative anesthetic process are associated with significantly increased OR efficiency.Objective To assess the relationship of preoperative physical function, as measured by Patient-Reported Outcome Measurement Information System Physical Function (PROMIS PF), to improvement in mental health, as eval

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