A sub-specialised emergency general surgery on call can improve theatre utilisation
Keywords:Theatre utilisation, Emergency operating, Theatre efficiency
Background: Theatre efficiency and delivery of a safe emergency general surgery service are important topics in the current climate of limited funding and resources. No studies have examined the impact of restructuring a general surgery emergency on call system on theatre utilisation and efficiency.
Methods: Data was collected for twelve months prior and twelve months after the introduction of a sub-specialised on call system on operating minutes, out of hours operating and which procedures were done after 10 PM using a prospectively maintained database. Theatre utilisation was calculated and compared using a paired T test.
Results: In 2012, between 8 AM and 5 PM, 993 emergency procedures were done in 2012 compared 1300 in 2015 corresponding to 34585 and 90311 minutes of operating respectively and 17.5% and 45.8% of total theatre time available (p<0.05). 160 procedures in 2012 were performed after 10 PM and 106 in 2015 corresponding to 16457 and 9341 minutes respectively (p<0.0001).
Conclusions: A sub-specialised emergency general surgery on call system can improve theatre utilisation.
Barlow AP, Wilkinson DA, Wordsworth M, Eyre-Brook IA. An emergency daytime theatre list: utilisation and impact on clinical practice. Ann R Coll Surg Engl. 1993;75(6):441-4.
Symons NRA, McArthur D, Miller A, Verjee A, Senapati A. Emergency general surgeons, subspeciality surgeons and the future management of emergency surgery: results of a national survey. Colorectal Dis. 2019;21(3):342-8.
Heng M, Wright JG. Dedicated operating room for emergency surgery improves access and efficiency. Can J Surg. 2013;56(3):167-74.
Devlin HB. Findings of the NCEPOD report for 1990. British J Hospital Med. 1991;47(10):723-4.
NCEPOD Report 1993/94. Provision of 24-hour emergency operating. NCEPOD, Nov 1996. Available at: https://www.ncepod.org.uk/ 1994report/1993_4sum.pdf. Accessed on 15 July 2017.
NCEPOD Report 1995/96. Who Operates When? NCEPOD, Sep 1997. Available at: https://www.ncepod.org.uk/1996report/1995_6sum.pdf. Accessed on 15 July 2015.
Who Operates When? II. NCEPOD Report 2003. Available at: https://www.ncepod.org.uk/ 2003wow.html. Accessed on 10 April 2016.
The NCEPOD Classification of Interventions. NCEPOD, Dec 2004. Available at: https://www.ncepod.org.uk/classification.html. Accessed on 15 June 2016.
Friedman DM, Sokal SM, Chang Y, Berger DL. Increasing operating room efficiency through parallel processing. Ann Surg. 2006;243(1):10-4.
Harders M, Malangoni MA, Weight S, Sidhu T. Improving operating room efficiency through process redesign. Surgery. 2006;140(4): 509-514
Archer T, Macario A. The drive for operating room efficiency will increase quality of patient care. Curr Opin Anaesthesio. 2006;19(2):171-6.
Munoz E, Tortella BJ, Jaker M, Sakmyster M, Kanofsky P. Surgical resource consumption in an academic health consortium. Surgery. 1994;115(4):411–6.
Ramesh S, Dehn TC, Galland RB. A traumatic deterioration in general surgeons access to emergency theatre. Ann R Coll Surg Engl. 1997:79(2):66-7.
Scriven MW, Pye JK, Masoud A, Crumplin MK. The use and impact of a daily general surgical emergency operating list in a district general hospital: a prospective study. Ann R Coll Surg Engl. 1995;77(3):117-20.