The Importance of Surgical Cutting Time as a Key Performance Indicator Alongside Touchtime Utilisation in Operating Theatre Efficiency Optimisation.

Aims The Getting It Right First Time (GIRFT) programme has set targets to achieve 85% touchtime utilisation by 2024/25. Touchtime utilisation is a measure of theatre productivity, defined as the time from the start of anaesthesia to the time a patient leaves the theatre for all cases on a defined theatre list as a percentage of total available theatre time. No published evidence examines touchtime utilisation as a measure of theatre efficiency and its correlation with surgical cutting time. This study aims to determine if there is a statistical relationship between touchtime utilisation and surgical cutting time, and whether the use of touchtime utilisation is sufficient to inform about surgical productivity. Methods A retrospective analysis of two orthopaedic theatres spanning 100 days at both a major trauma centre and an elective hospital in London was performed. Electronic records identified anaesthetic start time, knife-to-skin time, end-of-procedure time, and patient-leaving-theatre time. Time intervals were calculated and the relationship between touchtime utilisation and surgical cutting time was assessed using Pearson's correlation coefficient (r). Results The mean total touchtime was 403 minutes (SD, 84 minutes) at the major trauma centre and 383 minutes (SD, 103 minutes) at the elective hospital. The mean total surgical cutting time was 259 minutes (SD, 72 minutes) at the major trauma centre and 233 minutes (SD, 75 minutes) at the elective hospital, from a total available time of 510 minutes per list. There was a significant correlation between touchtime and surgical cutting time at both hospitals (elective hospital: r (198) = 0.815, p < 0.001; major trauma centre: r (198) = 0.892, p < 0.001). The mean touchtime utilisation was 79.31% for the major trauma centre and 75.20% for the elective hospital; however, the mean total surgical cutting time was 51% and 46%, respectively, of total available time. Conclusion Despite a good correlation between touchtime and surgical cutting time, the range between these measures suggests that using touchtime utilisation alone to measure theatre efficiency may not sufficiently inform about efficient practices. We suggest complementing touchtime utilisation data with surgical cutting time may provide more information to contextualise efficiencies or inefficiencies in an operating theatre.