Audit of the Functioning of the Elective Neurosurgical Operation Theater in India: A Prospective Study and Review of Literature

Saikia, Amrit Kumar; Sriganesh, Kamath; Ranjan, Manish; Claire, M. le; Mittal, Mohit; Pandey, Paritosh

doi:10.1016/j.wneu.2015.03.031

Cited by 6 publications

(19 citation statements)

References 14 publications

(13 reference statements)

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“…Our mean TUT was 47% which is comparable to published literature (56%-70%) (Iyer 2004, Saikia 2015. It is worth noting that our hospital is a training centre and some of the procedures are performed by trainees which can prolong surgical time when compared with other studies.…”

Section: Discussionsupporting

confidence: 80%

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Analysis of Neuro-theatre Utilisation and Reasons for Cancellation to Improve Efficiency and Productivity

Sharouf

Mirza

Moosajee

et al. 2017

Journal of Perioperative Practice

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In neurosurgery, much emphasis has recently been placed on theatre cancellation and time utilization as a key hospital management performance indicator. We sought to evaluate our unit's theatre throughput efficiency and identify the causes of elective surgery cancellations. We retrospectively audited all scheduled elective neurosurgical procedures over a period of nine months. Mean theatre utilization time was 47.0%. The common causes of cancellations were lack of theatre time (32%), non-availability of beds in recovery room (18.6%), and insufficient preoperative patient preparation (5.5%). Inefficiencies were noted in turnover of patients and inaccurate prediction of operative time. Our theatre utilization time is consistent with available literature; however, cancellations of elective surgery waste valuable operative time and resources. The study concludes that a multi-dimensional approach must be taken to improve theatre utilization and reduce cancellation rates. A pre-assessment clinic has been introduced in order to reduce cancellation rates.

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Section: Discussionsupporting

confidence: 80%

“…Three studies investigated theatre efficiency and cancellation in neurosurgery and showed variable TUT, ranging from 56% to 70% (Iyer 2004, Saikia 2015, Kamat 2015.…”

Section: Literature Reviewmentioning

confidence: 99%

Analysis of Neuro-theatre Utilisation and Reasons for Cancellation to Improve Efficiency and Productivity

Sharouf

Mirza

Moosajee

et al. 2017

Journal of Perioperative Practice

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“…Among the 20 included studies, nine (45%) introduced perioperative management methods in common for all elective surgeries (27)(28)(29)(30)(31)(32)(33)(34)(35). There were four studies each on preoperative methods for general surgery (36-39) and for neurosurgery (40)(41)(42)(43), two articles for eye surgery (44,45) and one article for head and neck surgery (46). Nineteen of the 20 studies investigated speci c, institution-based interventions.…”

Section: Synthesis Of Resultsmentioning

confidence: 99%

“…Saikia (40) reported a prospective observational study to evaluate the OT utilisation in a neurosurgery unit of a teaching hospital in India. Data were collected over 78 days and revealed that operating and anaesthetic time for different neurosurgical operations could be used as a guide for planning operating lists.…”

Section: Synthesis Of Resultsmentioning

confidence: 99%

“…Measured outcome variables were heterogeneous across the included studies. Eight studies reported overall OT e ciency (6, 28, 32,33,36,43,44,50) and eight studies reported overall OT utilisation (27,29,31,39,40,(44)(45)(46). Some studies focused on single process improvement approach in perioperative processes (29-31, 35, 41, 42, 44, 45, 50) but other studies targeted on preoperative time management with multiple approaches (27, 28, 32-34, 36, 37, 39, 40, 43, 46).…”

Section: Outcomes and Interventionsmentioning

confidence: 99%

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Efficient perioperative time-management methods for operating theatres: a systematic review showing how to reduce overall patient waiting times for elective surgery

Rathnayake¹

2021

Preprint

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Introduction: The effects on long waiting times for elective surgeries from lower operating theatre (OT) performance have been reported in many studies. The timeliness of perioperative processes and adherence to scheduled times is crucial for efficient performance in OT but the perioperative workflow includes multiple tasks assigned to different work teams. Each of these needs to be completed in a timely manner. This systematic review investigates the effects of efficient preoperative systems on the timeliness of upstream and downstream processes in surgical care pathways in order to reduce overall patient waiting times for elective surgery. Methods: We searched PubMed, EMBASE, SCOPUS, Web of Science and Cochrane Library databases during December 2019 and January 2020, for articles published after 1 January 2014. All studies pertaining to perioperative time-management methods, which had an intention to reduce waiting times for elective surgery were eligible for this review. Eligibility criteria included major elective surgery lists of adult patients, excluding cancer and cancer-related surgeries. Both randomized trials and non-randomized controlled studies were considered and the quality of studies was assessed using ROBINS-I and CASP tools. The review findings are presented as a narrative synthesis due to the heterogeneity of included studies. The PROSPERO registration is CRD42019158455. Results: The electronic search yielded 7543 records and 20 articles were eligible after deduplication and full article screening. There were two experimental studies, five quasi-experimental studies and 13 observational studies. The studies varied widely in design, scope, reported outcomes and overall quality. The first-case-start-time and patient change-over-time at OT were the main time related measures considered as affecting timeliness in many studies. Conclusion: This review suggests that a significant amount of time could be saved with efficient scheduling and planning perioperative processes, which could reduce overall patient waiting time for elective surgeries. Managing perioperative time in isolation could be an enabling factor for an overall increase in both theatre utilisation and theatre efficiency. However, only a small number of good quality studies were available and further evaluation with higher quality study designs and rigour is recommended in order for firm conclusions to be reached.

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A hidden opportunity within surgery in low- and middle-income countries

et al. 2016

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Audit of the Functioning of the Elective Neurosurgical Operation Theater in India: A Prospective Study and Review of Literature

Cited by 6 publications

References 14 publications

Analysis of Neuro-theatre Utilisation and Reasons for Cancellation to Improve Efficiency and Productivity

Analysis of Neuro-theatre Utilisation and Reasons for Cancellation to Improve Efficiency and Productivity

Efficient perioperative time-management methods for operating theatres: a systematic review showing how to reduce overall patient waiting times for elective surgery

A hidden opportunity within surgery in low- and middle-income countries

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