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KEYWORDS Theatre time / Operative time / Anaesthetic time / Turnover time
A prospective review of theatre time utilisation of the senior author's elective orthopaedic lists was carried out over a period of 10 weeks. A total of 41 cases were included. Only 54.0% of theatre time was utilised for operating. The anaesthetic time was 12.0%, and 9.3% of theatre time was used for positioning and draping. Delays in starting the list and turnover time accounted for the remaining 25%.
Introduction
Efficient utilisation of theatre time is important for efficient cost-effective theatre running. Better theatre utilisation means shorter waiting lists and less waiting on the wards. For surgeons, theatre utilisation is often used as an index of the surgeon's performance, and this may become a tool of appraisal in the future (Opit 1991, Faiz 2008). Theatre time is an expensive and limited resource, with an average hourly cost of about £500 (O'Keefe 2010, BTHF Trust 2010, WHH Trust 2009/2010). In addition, theatre time utilisation is one of the Indicators of hospital performance (Faiz 2008). Improving theatre utilisation is imperative to maintaining the financial viability of NHS trusts, through reducing cost and increasing theatre throughput as well as meeting waiting list targets.
Previous studies in other surgical specialties, including general surgery and neurosurgery, have indicated that only between 49 and 60% of available theatre time was utilised in actual operating, with the rest spent on other activities such as patient turnover and anaesthetic time (Haiart et al 1990, Lyer et al 2004). A study in 1994 showed similar findings in elective orthopaedic surgery (Ricketts et al 1994). Whilst these studies served to identify the percentage of theatre time used for operating, they failed to detail different parts of the turnover time where efficiency could be improved.
The aim of this study was to assess theatre time utilisation at a teaching district general hospital in the UK and to identify areas for potential improvement in the efficacy of using theatre time.
Materials and methods
The study was carried out in a teaching district general hospital, which had eight orthopaedic consultant teams, two daily elective orthopaedic theatres and one daily trauma theatre list. A prospective review of the timing of events in theatre was carried out...