Enhancing the Efficiency of Operating Theatre Turnaround Time via Process Mapping and Multi-Discipline Collaboration

Abstract Description

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Authors (including presenting author) :

Wong DHJ(1), Chu PWC(2), Kwan WY(1), Tsang CM (1), Law HTE(1), Chan NF(1), Ho SY(1), Li LL(1), Mak SC (1), Ng WY(1), Wong LH(1), Wong PS(1), Wong KSK (3)

Affiliation :

(1)Department of Anesthesiology & Operating Theatre, North District Hospital, (2)Department of Anesthesiology, NDH/AHNH, (3)Hospital Administration Department

Introduction :

The Turnaround time (TAT) of Operating Theatre (OT) has a broad and significant impact on hospital administrators, health care services and patients (Hoffman, 2018). It can affect the capability of the utilization of OT for scheduled lists. TAT in Hospital Authority (HA) is defined as the time from the patient finished the operation and transferred out of the theatre to the next patient enters into the theatre. TAT can be variables from 5 to 60 minutes due to multitude tasks such as the time for counting of used instruments, cleansing the theatre, transport the patient to PACU. In order to improve the TAT at NDH, process mapping and multidiscipline collaboration were applied to identify opportunities for reducing the TAT. This paper summarizes the overall approach used by the team, associated findings, results for performance metrics, and potential future improvements.

Objectives :

ｰ To reduce TAT between surgical cases ｰ To improve the capability for fully utilization of theatres ｰ To promote a safe and efficiency surgical environment

Methodology :

PDCA cycle was adopted for the TAT project (A). Plan - Establish a taskforce workgroup - Review and evaluate the current practice for TAT work flow - Set the TAT target to the HA mean - Invite Anesthesiology department, administration department, outsourced cleansing team to join the improvement project (B). Do - Process mapping to identify the opportunities to reduce TAT, e.g. set the target for the cleansing team to tidy up and clean the theatre within 10 mins, designated nurse to perform checking process to shorten handover time - Arrange meetings to discuss with Anesthetists, Administration officer, Cleansing Team, nursing staff and supporting staff about our target of TAT (C). Check - Periodical assessment is performed to evaluate the effectiveness of the new implemented strategies. Collected feedback from stakeholders for general comments (D). Act - Compare the TAT between different specialties to analyze the gaps and identify the opportunities to improve the TAT.

Result & Outcome :

1. Compared 2017 data, the mean of the turnaround time from Jan. 2018 to Oct. 2018 is significantly improved. The mean of turnaround time for different specialties has dropped: - Dental surgery (from 15 to 11 minutes) - Gynecology (from 15 to 10 minutes) - Orthopedics (from 22 to 14 minutes) - General surgery (from 21 to 15 minutes) 2. A good caring team is established by the designated nurse to enhance patients' safety. 3. The pre-operative caring team can perform the role to collaborate other disciplines such as medical and allied health staff to further promote the holistic care for patient at OT.