Advertisement
Research Article| Volume 58, ISSUE 9, P1139-1144, November 2020

Download started.

Ok

Determinants of lost theatre capacity

Published:August 28, 2020DOI:https://doi.org/10.1016/j.bjoms.2020.07.034
Determinants of lost theatre capacity
Previous ArticleCan we justify the continued use of botulinum toxin A in the management of myofascial pain?
Next ArticleChanging trends in the management of condylar fractures

      Abstract

      Secondary care Trusts nationwide are continuing to fail the 18-week referral to treatment (RTT) target despite several initiatives to improve theatre efficiency (2018 NHS England review). A limitation of wasted theatre productivity is required to alleviate pressures on waiting lists. Productivity, which is a measure of treatment time as a proportion of available/allocated time, takes into consideration variations in operator performance, early (non-funded) theatre starts, and over-run, and its analysis enables the determination of theatre downtime and lost theatre capacity. We monitored productivity over a 12-week period and performed downtime analysis as reported in the NHS Improvement national audit (NHSI). Results showed a marked but predictable variation in productivity connected to turnaround and session list scheduling. Productivity and booking efficiency correlated uniformly (Pearson’s r = 0.82). Theatre downtime was analysed with respect to three components defined in the NHSI national audit: late starts, early finish, and turnaround. We found that lost theatre time was predominantly due to early finishes; late starts were infrequent. Transport time correlated unfavourably with productivity (Pearson’s r = -0.29, p = 0.037) and over-run (r = 0.44), and prolonged transport times were shorter when surgery was performed in a dedicated day surgery unit. Calculating the mean transport times for lists with high compared with low productivity helped us set a benchmark for patient transport times for future audit.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to British Journal of Oral and Maxillofacial Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Register: Create an account
      Institutional Access: Sign in to ScienceDirect

      References

      1. Consultant-led referral to treatment waiting times data 2018-19. NHS England. Available from URL: https://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/rtt-data-2018-19/. (last accessed 2/07/2020).

        View in Article

      2. Operating theatres: review of national findings. Audit Commission, 2003. Available from URL: https://webarchive.nationalarchives.gov.uk/20150423183452/http:/archive.audit-commission.gov.uk/auditcommission/subwebs/publications/studies/studyPDF/3023.pdf. (last accessed 2/07/2020).

        View in Article

      3. Theatre savings flow from TPOT approach. Health Financial Management Association (HFMA). Available from URL: https://www.hfma.org.uk/docs/default-source/publications/case-study/theatre-management.pdf?sfvrsn=2. (last accessed 2/07/2020).

        View in Article

      4. Evaluation of the Productive Operating Theatre programme. NHS Institute for Innovation and Im-provement, 2013. Available from URL: http://harmfreecare.org/wp-content/files_mf/Evaluation-of-The-Productive-Operating-Theatre-programme-FINAL.pdf. (last accessed 2/07/2020).

        View in Article

      5. Operating theatres: opportunities to reduce waiting lists. NHS Improvement, 2019. Available from URL: https://improvement.nhs.uk/documents/3711/Theatre_productivity_report__Final.pdf. (last accessed 2/07/2020).

        View in Article
        • Pandit J.J.
        • Abbott T.
        • Pandit M.
        • et al.
        Is’ starting on time’ useful (or useless) as a surrogate measure for’ surgical theatre efficiency’?.
        Anaesthesia. 2012; 67: 823-832
        View in Article

      7. Operational productivity and performance in English NHS acute hospitals: unwarranted variations. An independent report for the Department of Health by Lord Carter of Coles, 2016. Available from URL: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/499229/Operational_productivity_A.pdf. (last accessed 2/07/2020).

        View in Article
        • McIntosh C.
        • Dexter F.
        • Epstein R.H.
        The impact of service-specific staffing, case scheduling, turnovers, and first-case starts on anesthesia group and operating room productivity: a tutorial using data from an Australian hospital.
        Anesth Analg. 2006; 103: 1499-1516
        View in Article
        • Delaney C.L.
        • Davis N.
        • Tamblyn P.
        Audit of the utilization of time in an orthopaedic trauma theatre.
        ANZ J Surg. 2010; 80: 217-222
        View in Article
        • Halim U.A.
        • Khan M.A.
        • Ali A.M.
        Strategies to improve start time in the operating theatre: a systematic review.
        J Med Syst. 2018; 42: 160
        View in Article
        • Fletcher D.
        • Edwards D.
        • Tolchard S.
        • et al.
        Improving theatre turnaround time.
        BMJ Qual Improv Rep. 2017; 6 (u219831.w8131)
        View in Article

      Article info

      Publication history

      Published online: August 28, 2020
      Accepted: July 27, 2020

      Identification

      DOI: https://doi.org/10.1016/j.bjoms.2020.07.034

      Copyright

      © 2020 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

      ScienceDirect

      Access this article on ScienceDirect

      The content on this site is intended for healthcare professionals.


      We use cookies to help provide and enhance our service and tailor content. To update your cookie settings, please visit the Cookie Preference Center for this site.
      Copyright © 2023 Elsevier Inc. except certain content provided by third parties.


      RELX