Theatre lists starting on time
In February 2011 Urology Theatres, Bev Stokes Day Surgery Unit and the Hand Unit achieved their first level target of 70% of lists starting on time. This was an improvement from their baseline in Autumn 2010 when less than 40% of lists were starting on time.
Some of the changes being trialled are:
- agreed time for team brief 8:20am and 1:20pm
- verbalising actual start time and reason for delay of first patient for record on ORMIS.
- PACU bring first patient to theatre when they can when theatres are short of staff
- Anaesthetics staff check the sickness line at 8:00am and report any issues to the co-ordinating Lead Practitioner.
- Co-ordinating Lead Practitioner has access to the sickness lines for all theatres to help them get an earlier picture of staffing issues.
At the Northern General Hospital site in particular start times are impacted by the availability of post operative beds. With the support of the bed managers the Arthroplasty pilot theatres, have taken a ‘leap of faith’ of starting the theatre list before bed availability has been confirmed. This has improved their start times by 25% and enabled the team to address issues in the process that were previously masked by the inpatient bed issue.
Improving Patient Flow to Increase Utilisation of Lists
The theatre team, ward staff, anaesthetists and surgeons in the Hand Unit have worked together to redesign the flow of patients through hand unit theatres. Training support has been given to enable ward staff to support the patients in theatre. This has enabled the theatre team to support a local anaesthetic case in theatre whilst a patient is being administered with an axillary block in the anaesthetic room. Another local anaesthetic case in carried out in theatre whilst the axillary block takes effect. This has helped to increase in hours utilisation of theatres by 10% and improved start times dramatically.
Project Lead: Lynn Skelton and Nicola Platts (Service Improvement Manager), Highly Productive Operating Theatre, Sheffield Teaching Hospitals NHS Foundation Trust, 0114 226 6031. Lynn.Skelton@sth.nhs.uk or Nicola.Platts@sth.nhs.uk