Flow of Emergency Theatre Cases at Hornsby

Published 17 September 2018. Last updated 1 October 2018.

This project will improve the safety and efficiency of the emergency surgical patient journey.


  • Increase the number of patients who are admitted to theatre within their emergency surgery category to 100%.
  • Improve patient and carer satisfaction for communication and wait times.


  • Safer patient emergency surgical journey.
  • Better patient communication regarding the booking process and surgical journey.
  • Decrease in emergency surgery delays.
  • Decrease in last minute cancellations.
  • More efficient emergency surgery lists.
  • Improved communication between medical and nursing staff.
  • More efficient use of staff resourcing.


In recent years, perioperative services at Hornsby Ku-ring-gai Hospital have undergone significant change including a major capital infrastructure redevelopment in 2015. The Stage 1 Hornsby Ku-ring-gai Hospital redevelopment has seen an increase in the number of operating theatres from four to eight. As a result there has been a significant increase in perioperative service activity, including 35 new staff, over a short period of time.

The increase in capacity, demand for emergency surgery services, and activity, has highlighted significant issues for the patient journey. Key performance indicators for emergency surgery are divided into six categories. Categories one to three require 100% achievement. During the period July 2017 to August 2017, perioperative services did not achieve the key performance indicators in Category 1 and Category 2.

Patient delays were occurring due to poor communication between medical and nursing staff including delays in availability of speciality equipment, surgeon availability, patient location and fasting times.


The following solutions will improve skills, knowledge and communication between medical officers and nurses across the patient journey.

  • Develop a flowchart for medical officers to use when booking in emergency patients.
  • Allocate a team leader for each theatre.
  • Create an in-charge checklist for booking in patients.
  • Develop an in-charge nurse training program.
  • Provide education for medical staff at orientation and via WIKI.
  • Implement STREAM Program.
  • Develop a formal process for patients presenting to emergency department, including assessment and decision to attend theatre the next day.


Implementation – the project is ready for implementation or is currently being implemented, piloted or tested.


  • 26 June 2017: project commencement
  • December 2018: planned completion

Implementation site

Perioperative Services – Hornsby Ku-ring-gai Hospital


Centre for Healthcare Redesign


The project evaluation will be ongoing from the start of implementation in September 2018 through to project completion in December 2018. Evaluation includes monitoring and reviewing surginet data for theatre use, patient surveys, medical officer and nursing staff surveys, and surginet reporting of achieved key performance indicators.

Lessons Learnt

  • Completing this project solo caused unavoidable delay throughout the process.
  • Having ongoing support for the project is imperative, never stop talking about it.


Allanah Hazelgrove
Nurse Unit Manager
Perioperative Services
Hornsby Ku-ring-gai Hospital
Phone: 02 9485 6400


Fill in our feedback form to find out more about this project or get in touch with the project manager.

Is this your project?

Fill in our feedback form to update your story or contact details.

Browse similar projects

SurgeryPatient flowNorthern SydneyEmergencyMetropolitanCentre for Healthcare Redesign
Back to top