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St Vincent's Hospital Surgery Redesign

St Vincent's Hospital
Project Added:
13 July 2012
Last updated:
17 October 2014

St Vincent's Hospital Surgery Redesign

by LZ Kershaw, S Whalen, L Black, C Tsang, G O’Sullivan, A Grabs
St Vincent's Hospital, NSW


Anecdotal evidence of significant inefficiencies and widespread surgeon dissatisfaction with the operating theatre service, triggered a program of work commencing in January 2011 to improve theatre efficiency and redesign surgical patient flow at St Vincent's Hospital, Darlinghurst.


A multi-pronged approach was instigated that included an emergency surgery demand and capacity analysis, stakeholder consultation, patient stories, process analysis and review of governance and performance management systems.

A range of strategies have been instituted including:

  • development and implementation of patient flow business rules
  • changes to the operating theatre schedule and increase in emergency theatre time 
  • role redesign to better use existing skills and knowledge
  • redesign of the pre-admission clinic and pre-admission processes 
  • sustainable staffing strategies for peri-operative unit
  • IT systems to better support communications
  • changes to Operating Theatre Management Committee and a balanced scorecard approach.

Work continues on pre-admission processes.


Findings of the diagnostic phase demonstrated a range of issues including invisibility of performance measures, ambiguity of the theatre start time, demand capacity mismatch and inconsistent use or absence of business rules and multiple workarounds.

Results include a reduction in elective day of surgery cancellations from an average of over 8.4% to 3.9% and achieving the target (less than 2%) in November 2011.

On time starts have improved from 37% to 55% and theatre throughput has increased with no increase in staffing or budget.

Lessons learned

Redesign programs that increase the transparency of performance measures can significantly assist improved performance and engage staff, provided there are supporting structures and appropriate leadership.


Project Officer Decision Support
St Vincent's Hospital
390 Victoria Street Darlinghurst, NSW 2010
Phone: 02 8382 2076

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