PFC 2005 - Operating theatres : Patient Flow Collaborative - Victorian Government Health Information, Australia


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Patient Flow Collaborative II - Outpatients

PFC 2005 - Operating theatres

To increase the utilisation and quality of care within operating theatres.

Review operating theatre utilisation (see tool kit)
Scheduling
Identify system to report delays daily via agreed criteria
Remove delays, complexity and hand offs within administration process
Smooth process from Emergency Department / Inpatient wards to Operating Room and back to ward
Review stages of Transfer from ward /Emergency Department, recovery to ward
Review capacity and demand for emergency and elective theatre
Review role of theatre coordinator and joint work with Pre-Operative and bed management
Review equipment turn around times via Central Sterilising Services Department and booking of equipment
Review recovery and transfer procedures - develop appropriate 'pull' process to theatre/wards
Establish pull systems from OR to ward via anaesthetic nurse/recovery nurse; to decrease down time (emergencies ready)
Identify pre call system to warn ward of delays or on way for patient
Develop multi disciplined staff to transport patients
Develop day case categories to monitor and champion the use of day case surgery
Identify surgical day case champion
Increase 23-hour stay unit beds
Develop theatres that can be used for day case lists and in-patients increasing utilisation with casemix and patient type variation
Establish day case units with nurse led admission and discharge criteria
Develop theatre hit squad to boost management of areas under strain
Increase nurse champions within theatre teams
Establish team improvement team trained in improvement skills

Delays
- Monitor theatre delays for one week to agree on the top 10 reasons for delays in theatre. When this is agreed, 4 weeks data will be collected against the top 10 delays. Once 4 weeks of 10 delays have been gathered SPC charts will need to be produced. Time needs to be collected against each reason(s) per day. As the top ten offenders may not amount to the longest waste in time.
Late Starts / Early Finishes / Overruns
Major Procedures (>1hr) v Minor Procedures (<1hr)
Lost time due to Cancellation for "No Bed"