Improving Operating Theatre Efficiency

So if there was one thing, if you were the theatre manager or head of a department listening to this and you said, one thing I could fix this month that would change theatre efficiency, where would you start?

If it was one part of that journey, I would focus on on-time starts is probably what I would focus on.

Just the momentum of starting early and on time, I think, is probably the single most important step.

And where there's the least confounders, where you haven't already run into...

the first case is running late, now the second one's running late.

That first case of the day, most often, most theatres are still empty and you get a good chance of having all your staff there to just start on time.

That's what I would focus on.

And what about for a clinician or a junior clinician? They've got no authority to change rosters or booking systems.

Is there anything they can personally do differently to help the system flow better?

The free one is to flag where you're up to early.

So notifying your nursing staff in your theatre and the full coordinator or the CRC about where you're up to in your list so that the next case can keep coming.

You can have a system where the next patient is always at least has been sent for and is waiting.

before you finish your first case.

And that doesn't cost any extra money.

And that's a nice way that if you're running an emergency list, just aiming in your mind, hey, can I notify people and send for the next patient early enough so that when I finish this case, they're here, their consent's been checked, they're faster, they're ready to go.

I think that's a free way for junior staff to make theatres run more efficiently.

Because as you said before, it's often no one's responsibility.

It's like, you know, has anyone sent for the patient?

Yeah.

So since you designed this course and you've thought a lot about this, What's the one thing that you do differently in your own practice now as a result of all this?

The biggest thing is to, if you see any delay or systems problem or a near miss, is to think about the system and try to speak to someone who's involved with that part of the theatre process about what led to that delay or misinformation and how we could improve it later.

And I feel empowered to talk about what else you could do is get a group of like-minded people from the perioperative area and have them either meet in person or even just have an email or a Teams chat where they can discuss issues and put forward ideas.

Because in that committee, when you raise these ideas, it's amazing how much you can improve when you have 10 or 12 people working together monthly, all with some... authority and I guess power to improve systems.

So I take those things that I see, have a chat with people who are important in that process, take it to the turn meeting, that's what it's called in our hospital.

And then it takes time, but you see the systems improve.