The effect of overlapping surgical scheduling on operating theatre productivity: a narrative review

Abstract

Summary This article reviews the background to overlapping surgery, in which a single senior surgeon operates across two parallel operating theatres; anaesthesia is induced and surgery commenced by junior surgeons in the second operating theatre while the lead surgeon completes the operation in the first. We assess whether there is any theoretical basis to expect increased productivity in terms of number of operations completed. A review of observational studies found that while there is a perception of increased surgical output for one surgeon, there is no evidence of increased productivity compared with two surgeons working in parallel. There is potential for overlapping surgery to have some positive impact in situations where turnover times between cases are long, operations are short (<2 h) and where ‘critical portions’ of surgery constitute about half of the total operation time. However, any advantages must be balanced against safety, ethical and training concerns.

The effect of overlapping surgical scheduling on operating theatre productivity

“…We read with interest the article by Pandit et al. [1] and agree with their analysis of overlapping surgery, patient safety and actual productivity. Overlapping surgery is often seen in large tertiary centres and, while it may feel more productive for one surgeon, in our opinion the benefits only exist with a simplified surgical list.…”

Modelling the economic constraints and consequences of anaesthesia associate expansion in the UK National Health Service: a narrative review

“…In this way, surgical downtime is eliminated with the appearance of significantly greater efficiency. However, modelling of the workflows for high-intensity lists has already shown that they can never be more productive than two separate theatres with their own teams, 64 and that they are considerably more expensive. 65 Therefore, even in this most extreme case, the use of AAs within such a working arrangement might to some extent address the latter (expense), if paid at appropriately lower rates, but will do nothing to address the former (productivity).…”

Four ways to fix the inefficiency of NHS surgery

“…Overlapping surgical scheduling should, however, be viewed with “great caution,” they concluded 7. They found there was “no evidence of increased productivity” compared with two surgeons working in parallel on their own well planned lists.…”