419 District General Theatre Efficiency: What Is the Patient Experience?. (19th August 2022)

• Record Type: Journal Article
• Authors: Sambhwani, S; Essak, K; Rayan, F; Krishnaiyan, R; Khairandish, H; Hirschowitz, D
• Is Part Of: British journal of surgery. Volume 109(2022)Supplement 6
• Publication Date: 2022-08-19
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1093/bjs/znac269.336
• Languages: English
• ISSNs: 0007-1323

Abstract

Abstract: Aim: The NHS Institute for Innovations and Improvement (NIII) has determined that a £7 million saving can be achieved per trust by improving theatre efficiency. With an increasing influx of admissions and trauma, alongside increasing trends pertaining to the pandemic and winter pressures, it is vital to optimise our patients' journey. Method: The journey of transition from pre-theatre to recovery was mapped and retrospective data on a single weekday theatre trauma list was collected over a one month stretch using ORMIS and 77 patients were identified and analysed. Results: The average case load was found to be 3.7 cases with lowest case load during the end of the week. The average send time for a patient was documented to being 8:45 (range:8:15–9:934) with an average turnaround time being 65 minutes for the first case and 37 minutes for subsequent cases. The average knife-to-skin time was found to be 10:00 for the first case (range:9:21–10:34). The median intercase time (time take from the patient leaving theatre to the next patient entering theatre) was found to be 47 minutes (range:15–49). Conclusions: Causes for delays in theatre flow were largely multifactorial and this impacted the first patient the most leading to a knock-on effect on subsequent patients on the list. With the NIII attributing an efficiency cost of £24.77/minute, there is a lot to be gained by maximising theatre efficiency particularly with current limited resources. A joint surgical and anaesthetic quality improvement project focusing on the golden patient was introduced with a patient focused approach.