Original research
A surgeon-led model to improve operating theatre change-over time and overall efficiency: A randomised controlled trial

https://doi.org/10.1016/j.ijsu.2016.04.033Get rights and content
Under an Elsevier user license
open archive

Highlights

  • The change-over period between operative cases is a significant source of lost time.

  • Implementation of a standardised strategy can significantly improve this change-over time.

  • This study trials an easy to follow surgeon-led team-based model to improve this time.

  • The results and the estimated potential to save significant amount of resources is presented.

Abstract

Background

The non-operative time during the process of patient change-over between operating theatre cases is a significant source of delay and overall theatre inefficiency. The aim of this study was to integrate and trial a working strategy to improve this change-over time.

Method

This was a single-blinded, randomised controlled intervention study comparing a surgeon-led, team-based model of strategies versus routine patient change-over. This model was trialled by a single surgeon, and the primary outcome was the difference in change-over times compared with 4 other surgeons who were blinded and served as controls. Secondary outcome measures included overall differences in complications between the groups, and the number and differences in operative case cancellations due to inadequate theatre time.

Results

1265 patients were randomised into 5 general surgical lists, and included all major and minor cases. Median number of operative cases were 214 per surgeon, with an overall median change over time of 17.9 ± 3.7 min. Surgeon A in the intervention group had a median change-over time of 12.1 ± 5.4 min (p < 0.001), with a median difference of 8.5 min ± 21.4 min (p < 0.0001), translating to a 58% reduction in median change-over time between the intervention and control groups. There were no differences in complication rates amongst the groups. The intervention group had no cancellations due to lack of time, compared with 37 cancellations in the control group.

Conclusion

This study demonstrates a statistically significant improvement in median change-over times using this model. This re-design can be implemented without incurring extra costs, staff, or operating theatres.

Keywords

Parallel processing
Operating theatre/room efficiency
Operating theatre/room patient changeover/turnover
Non-operative time
Resource utilisation

Cited by (0)

The corresponding author is not a recipient of a research scholarship. This paper is not based on a previous communication to a society or meeting.