Abstract
Hospital operating theatres are a critical but costly resource in healthcare processes. Their efficiency and utilisation impact upon hospital finances, clinical effectiveness and patient outcomes. Operations management techniques have now been applied widely to optimise flow. An important challenge is to balance the needs of process flexibility, efficiency and work standardisation with clinical requirements. This paper applies operations management methods to analyse elective orthopaedic surgery at five international hospitals to describe the issues that affect operating theatre productivity. It utilises an innovative method of video analysis to observe patient changeovers over 29 days of surgery and data is analysed to understand the causes of variability and waste. The findings suggest that processes which are standardised via operations management methodologies can improve productivity in a process that exhibits wide variation in practice. There are apparent trade-offs associated with efficiency and clinical concerns such infection control, that lead to different standard process archetypes being utilised. Recommendations for standardising patient changeovers are provided.
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Acknowledgements
The authors would like to thank DePuy International Ltd for providing access to data and Warwick Innovative Manufacturing Research Centre (WIMRC) for funding the research. In addition, thank you to all the staff at the various hospitals who agreed to be recorded for this research but cannot be named for confidentiality.
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The authors have no competing interests to report.
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Meredith, J.O., Grove, A.L., Walley, P. et al. Are we operating effectively? A lean analysis of operating theatre changeovers. Oper Manag Res 4, 89–98 (2011). https://doi.org/10.1007/s12063-011-0054-6
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DOI: https://doi.org/10.1007/s12063-011-0054-6