Nottinghamshire University Hospitals NHS Trust believed that a transformation was needed within its 48 Theatres to increase efficiency by improving the number of operations undertaken in the planned theatre time available. It had key objectives of improving:
- Session Utilisation
- In-session Utilisation
- With improvements in both these measures the Trust aimed for an increase in the number of surgical cases being undertaken in the available theatre time therefore improving the income position of the Trust with minimal additional cost.
- These objectives needed to be achieved at the same time as improving surgical safety and reducing cancelled operations
Having attended a Financial Leadership programme delivered by Beffective in order to achieve these objectives the Theatre team undertook a full timetable review and initiated weekly theatre productivity meetings. Starting theatre lists on time was identified as the main opportunity for improvement.
Implementing what they had learnt on the programme specifically around Trust, Team members took time to meet with everyone who impacted on whether a theatre list would start on time, these included staff on wards, patient escort, and sterile services.
Having built the best timetable for surgical specialities and planned the use of theatre time effectively the ‘start
on time’ project built team work and confidence that operations would be completed in the planned time, reduced cancellations and encourage more cases to be scheduled on underutilised lists.
A 27% reduction in lost time due to late starts, equivalent of 810 hours a week with a value in theatre time of 655K per annum.
The programme has supported other initiatives in the Trust and has helped support a reduction in ‘on the day’ cancelled operations.
Within a matter of weeks improvement was evident, over a number of months the results demonstrated:
- A step change improvement in in-session utilisation
- with specialties meeting the 96% utilisation target.
- The scale of work within the 48 Theatres meant the
a small percentage change produced a large increase
in additional cases. The specialties with improved performance have undertaken more than 1,000 additional cases in equivalent planned theatre time (data 2013 -14). Financial impact of an additional 2.4 million.
- A safer surgery model that has resulted in no ‘never’ events in NUH theatres since 2012
Interview with Duncan Orme