Audit of the utilization of time in an orthopaedic trauma theatre

Abstract

We have highlighted inefficiency in the orthopaedic trauma theatre at our institution and suggest various strategies to improve this that may be applied universally.

Operating time for total knee arthroplasty in public versus private sectors: where does the efficiency lie?

“…Orthopaedic theatre efficiency can be measured by utilization time, the fraction of overall theatre time utilized by anaesthetic/ turnover time versus operating time. 8 Improvements in utilization time may be achieved through scheduling strategies, predetermined first cases, patient checklists, theatre flow coordinators and financial incentivisation. [9][10][11][12][13] Cullen et al compared standard public health cost effectiveness against a financially incentivized model within the public sector.…”

The effect of handover location on trauma theatre start time: An estimated cost saving of £131 000 per year

“…Although theatre wastage of 10 minutes is not acceptable, we have tried to cut this down considerably by trying to initiate a send for patient time of 08:10 am . Delaney et al discusses that late start times are an issue worldwide and that the presence of senior anaesthetists initially can reduce this burden. This is also the case in our new theatre‐briefing model.…”

“…Other ways efficiency can be improved have been suggested including improving patient transport to the theatre; addressing delays in sending for the patient (which can cause up to 50% of delays); improving multidisciplinary discussion at the start of the list, with presence of consultants; and improving turnover time with the presence of a “floating” anaesthetist, or by giving the anaesthetist more responsibility in sending for the patient . Some of these points are also suggested by the NHS modernization agency .…”

Are we operating effectively? A lean analysis of operating theatre changeovers

“…The remaining 34% was made up of late starts, early finishes and changeovers offering opportunities for improvements to productivity (NHS Confederation 2010). Other factors that impact productivity include theatre layout, late changes to surgical lists, availability of surgeons, inadequate preoperative preparation and a lack of instruments and equipment (Jacofsky and Lyman 2007;Delaney et al 2010). These causes are potentially controllable if learning from OM theory and practise were applied to standardise processes.…”

“…Previous research has used a range of measures for operating theatre productivity including: admittance time to discharge (Jacofsky and Lyman 2007), theatre utilisation (Delaney et al 2010), waiting time, throughput and patient deferrals (Cardoen et al 2010). Utilisation is the principal managerial measure of theatre performance across Trusts in the United Kingdom (Faiz et al 2008).…”