Operating Theatre Efficiency
The Operating Theatre Efficiency program aims to develop strategies for hospitals to improve theatre efficiency in NSW. These strategies will include the recommendations in Auditor General’s Report on Operating Theatre Efficiency.
The program will focus on three key areas:
The ACI and the Ministry of Health have established three working groups for each of the identified priority areas to progress the outcomes and discussions from the September Surgery Efficiency workshop. The three working groups are overseen by an Operating Theatre Efficiencies Steering Committee and the ACI Surgical Services Taskforce.
Efficient Operating Theatres on a Budget forum
|Measuring clinical variation to support quality improvementand transparency in healthcare systems (PDF 1MB)||Kim Sutherland, Director of System and Thematic Reports||Bureau of Health Information|
|Operating Theatre Efficiency Guidelines & Data Dictionary (PDF 1MB)||Gavin Meredith, ACI SST Manager & Phyllis Davis, NM OT||ACI , Prince of Wales Hospital, Sydney Children’s Hospital (Randwick) & Royal Hospital Women|
|OT Productivity Index - Theory (PDF 1MB)||Jennie Pares, Health Economist||Agency for Clinical Innovation|
|Fast Facts (PDF 1MB)||Leanne Creighton||Agency for Clinical Innovation|
|OT Scheduling Redesign (PDF 1MB)||Mary Rose, NM OT||Northern Sydney LHD|
|Emergency Surgery Redesign (PDF 1MB)||Jenny Dobson, ASU Nurse Practitioner||Nepean Blue Mountains LHD|
Operating Theatre Efficiency Guidelines
The Operating Theatre Efficiency Guidelines have been developed as a best practice guide for the management and governance of OTs in NSW public hospitals and are intended to provide assistance to OT committees, managers and staff in the management of efficient operating theatres at hospital and Local Health District (LHD) levels.
The Guidelines provide information on OT efficiency measures, management processes and cost considerations based on expert recommendations.
Efficiency Measures Working Group
The Efficiency Measures Working Group provides advice on operating theatre measures and KPIs that reflect efficiency and on process and responsibilities for data collection.
Considerations for the working group include data definitions, data quality, processes for data collection and data interpretation and analysis.
First case on time theatre starts
The First case on time theatre starts project aims to improve operating theatre efficiency by ensuring that patients receive timely and quality care at the appropriate time.
In order to assist in identifying the challenges involved in achieving the target, a short survey was developed to provide information about current work processes, including the steps preceding the patient’s admission. View the survey results (pdf - 65 KB).
The information received from the survey has assisted in the development of a 'first case on time starts' checklist.
Successful implementation of the Operating Theatre Efficiency Guidelines requires a collaborative multidisciplinary OT team approach.
To further assist sites to identify opportunities for improvement the ACI has developed an Operating Theatre Self-Assessment.
The tool is aligned to the efficiency guidelines and allows managers and clinicians to quickly identify areas to focus on for further investigation through the use of drop down questions and a dashboard.
Operating Theatre Standard Cost Template
The OT Standard Cost Template has been developed to improve the collection and allocation of OT costing data.
The template calculates an average cost per minute/session for a standard OT to facilitate modelling of OT costs for various scenarios.
Theatre Costing Working Group
The Theatre Costing Working Group provides advice on costs associated with the different elements of surgery, feasible costing measurements and measuring capital cost depreciation in operating theatres.
The average cost of a fully staffed operating theatre per hour of surgery in NSW has never been accurately defined. Accurate cost estimates should consider all elements of surgery such as staffing, consumables, wastage in the operating theatre and capital cost deprecation.
Whole of Surgery
Whole of Surgery Working Group
The Whole of Surgery Working Group provides advice on the responsibilities of managers within the operating theatre, effective structures for collaboration between management and clinical staff, and developing effective frameworks that promote efficiency in patient throughput and quality care.
There is a need for the operating theatre efficiency guidelines to provide direction on processes that can be employed by leadership, managers and operating theatre staff to enhance efficiency.
Considerations for the working group include management/leadership, models of care, staffing, and theatre size.
The Agency for Clinical Innovation (ACI) and the Ministry of Health hosted the Operating Theatre Efficiency workshop on Friday 20 September 2013.
Entitled, Time in, Time out, Time over! A fresh look at operating theatres!, this workshop was designed for surgeons, operating theatre managers, senior surgical clinical staff, and senior managers responsible for the performance of operating theatres.
- The Advisory Board Company. (2007). The High Performance OR: Elevating Efficiency Through Strategic OR Management
- Benchmarking the OR's key indicators. (2011). OR Manager, 27(2), 12-3. (CIAP link, NSW Health only)
- Levtzion-Korach, O., Murphy, K. G., M.D., Madden, S., & Dempsey, C. (2010). For urgent and emergent cases, which one goes to the OR first? OR Manager, 26(7), 1-3. Retrieved from (CIAP link, NSW Health only)
- McIntosh, C., Dexter, F., Epstein, R.H. (2006). The Impact of Service-Specific Staffing, Case Scheduling, Turnovers, and First-Case Starts on Anesthesia Group and Operating Room Productivity: A Tutorial Using Data from an Australian Hospital. Anesthesia & Analgesia. 103(6), 1499-1516. Doi: 10.1213/01.ane.0000244535.54710.28.
- Macario, A. (2010). What does one minute of operating room time cost? Journal of Clinical Anesthesia, 22(4), 233-236. (CIAP link, NSW Health only)
- Mathias, Judith M. (2011). Surgical scheduling: Taking an important role to the next level. OR Manager, 27(3), 1-3. Retrieved from (CIAP link, NSW Health only)
- Pandit, J., et al. (2012). Is ‘starting on time’ useful (or useless) as a surrogate measure for ‘surgical theatre efficiency’? Anaesthesia, 67 (8), 823–832.
- Patterson, P. (2010). Is your OR leadership team up to health care reform challenges? OR Manager, 26(6), 1-7. Retrieved from (CIAP link, NSW Health only)
- Patterson, P. (2011). OR dashboards: A useful tool for telling a story through data. OR Manager, 27(2), 1-9. (CIAP link, NSW Health only)
- Team agreement, competition boost record for on-time starts. (2010). OR Manager, 26(8), 1-1, 8, 10. (CIAP link, NSW Health only)
- Tracking data, changing behavior. (2011). OR Manager, 27(2), 10-1. Retrieved from (CIAP link, NSW Health only)
- What makes an OR “highly reliable”? (2010). OR Manager, 26(2), 16-8. (CIAP link, NSW Health only)
- Why are case-time estimates so often off? (2008). OR Manager, 24(4), 21-2. (CIAP link, NSW Health only)
Surgical Services Taskforces Manager
Agency for Clinical Innovation
Phone: 02 9464 4644