Theatre efficiency in COVID-19 pandemic conditions: The collaborative experience of four level 1 major trauma centres in the UK

Abstract

Aims As the world continues to fight successive waves of COVID-19 variants, we have seen worldwide infections surpass 100 million. London, UK, has been severely affected throughout the pandemic, and the resulting impact on the NHS has been profound. The aim of this study is to evaluate the impact of COVID-19 on theatre productivity across London’s four major trauma centres (MTCs), and to assess how the changes to normal protocols and working patterns impacted trauma theatre efficiency. Methods This was a collaborative study across London’s MTCs. A two-month period was selected from 5 March to 5 May 2020. The same two-month period in 2019 was used to provide baseline data for comparison. Demographic information was collected, as well as surgical speciality, procedure, time to surgery, type of anaesthesia, and various time points throughout the patient journey to theatre. Results In total, 1,243 theatre visits were analyzed as part of the study. Of these, 834 patients presented in 2019 and 409 in 2020. Fewer open reduction and internal fixations were performed in 2020 (33.5% vs 38.2%), and there was an increase in the number of orthoplastic cases in 2020 (8.3% vs 2.2%), both statistically significant results (p < 0.000). There was a statistically significant increase in median time from 2019 to 2020, between sending for a patient and their arrival to the anaesthetic room (29 vs 35 minutes; p = 0.000). Median time between arrival in the anaesthetic room and commencement of anaesthetic increased (7 to 9 minutes; p = 0.104). Conclusion Changes in working practices necessitated by COVID-19 led to modest delays to all aspects of theatre use, and consequently theatre efficiency. However, the reality is that the major concerns of impact of service did not occur to the levels that were expected. Cite this article: Bone Jt Open 2021;2(10):886–892.

A discrete event simulation for improving operating theatre efficiency

“…This has major implications for the way surgical services and operating theatres are managed, and the information needed to support that management. With hospitals already under pressure, most have faced additional strain arising from COVID‐19 hospitalisations with reports of delays to all aspects of theatre use, and consequently decreases in theatre efficiency 2–5 . Efficient theatre management is particularly important as many countries enter a ‘COVID‐19 normality’ moving from pandemic status to endemic.…”

Optimizing Surgical Care Amidst COVID-19: A Scoping Review of Practices and Policies

“…The effect of SARS-CoV-2 infection on operating room efficiency in London’s four busiest trauma centers was studied by Jeyaseelan et al They found that although the frequency of open reduction and internal fixation surgeries decreased in 2020, the number of orthopedic patients increased. The median time between sending a patient and their arrival in the anesthetic chamber increased significantly [ 67 ].…”

“…[ [21][22][23]25,26,[66][67][68] Head and Neck Facial trauma surgeries prioritized by urgency balancing transmission risks with time minimization key -under 5 minutes from incision to cuff inflation. Home drain removal successfully implemented for most neck surgeries, preventing hazardous in-person encounters while telemedicine managed rhinology cases effectively.…”