Keller Andrew, Ashrafi Akbar, Ali Ahmad
Department of Urology, Ipswich General Hospital, Chelmsford Ave, Ipswich QLD, 4305, Australia.
F1000Res. 2014 Aug 19;3:197. doi: 10.12688/f1000research.4824.1. eCollection 2014.
To evaluate our unit's theatre throughput efficiency, to identify where inefficiencies existed and consequently where the greatest improvement might be made.To identify the causes of day of surgery cancellations and how they might be avoided.
A prospective audit of theatre utilisation was undertaken over a 6 month period between 05/02//2013 and 02/08/2013 at Ipswich General Hospital, QLD, Australia.TIMES COLLECTED WERE: time of patient arrival in anaesthetic bay, start time of operative procedure, end time of operative procedure, and time of patient leaving theatre.The causative factors for any delays or day of surgery cancellations were identified and recorded where possible.
In the six month period 26,850 sessional minutes were available for elective operating over 100 operating sessions.304 elective cases were performed, split between 21 major and 283 minor proceduresThe sessions ran overtime a cumulative 2114 minutes.Total non-operative minutes totalled 13,209 (50.3% of all available time), split between late starts 499 minutes (1.8%), early list finishes 1894 minutes (7.05%), changeover time 1869 minutes (6.9%) and anaesthetic time, 8974 minutes (33.4%)Actual operating time only compromised 50.7% of all available elective operating session time (13,614 minutes)Theatre utilisation was 91.8%.51 procedures were cancelled on the day of surgery during the audit period, representing 14.3% of all scheduled procedures.The most common reason for cancellation was lack of surgical fitness, followed by inadequate operative time.
A significant proportion of all elective operative time was consumed by non-operative minutes.Inefficiencies existed in turnover of patients as well as over as well as underbooking of patients on elective lists.An excessive number of cases were cancelled on the day of surgery, wasting valuable operative time.A multi-parametric approach must be taken to improve operation list utilisation.
评估我院手术室的工作效率，确定效率低下之处以及最有可能取得最大改进的地方。找出手术当天取消手术的原因以及如何避免这些情况。
于2013年2月5日至2013年8月2日期间，在澳大利亚昆士兰州伊普斯威奇综合医院对手术室使用情况进行了为期6个月的前瞻性审计。收集的时间数据包括：患者到达麻醉区的时间、手术开始时间、手术结束时间以及患者离开手术室的时间。尽可能确定并记录任何延误或手术当天取消手术的相关因素。
在这6个月期间，100个手术时段共有26850个时段分钟可用于择期手术。共进行了304例择期手术，其中21例为大手术，283例为小手术。这些时段累计超时2114分钟。非手术总分钟数共计13209分钟（占所有可用时间的50.3%），其中包括迟到开始499分钟（1.8%）、提前结束手术清单1894分钟（7.05%）、转换时间1869分钟（6.9%）以及麻醉时间8974分钟（33.4%）。实际手术时间仅占所有可用择期手术时段时间的50.7%（13614分钟）。手术室利用率为91.8%。在审计期间，有51例手术在手术当天取消，占所有预定手术的14.3%。取消手术的最常见原因是患者手术条件不适合，其次是手术时间不足。
所有择期手术时间中有很大一部分被非手术分钟数消耗。患者周转以及择期手术清单上患者预约过多或过少都存在效率低下的问题。手术当天取消的病例数量过多，浪费了宝贵的手术时间。必须采取多参数方法来提高手术清单的利用率。
