NHS Elective Theatres

A large university hospital in North West England were looking to improve the performance and efficiency of the Elective Orthopaedic Theatres Operation. The approach was to focus on using Lean principles and hands-on methodology to design and implement a change programme which would result in major improvements.

Initial Observations

• Theatre lists were not maximised due to expected delays
• Staff expected delays as part of their working day
• No focus or pro-activity which ensures goodworkingpractice, particularly in the morning
• Planning was reactive
• Lack of information on the theatre list
• Ineffective communication between ward and theatre staff
• Equipment shortages and missing / faulty items
• Patient cancellations on day of theatre

Improvement Strategy

• Introduction of metrics and performance data to understand the cause of the delays
• Clearly defined roles and responsibilities
• Improve communications by specifying the information required to plan a successful day
• QCO Quick Changeover (SMED) to eradicate delays on the day of Theatre by planning the day before
• PROBLEM & COUNTERMEASURE
  Problem countermeasure introduced to identify issues, responsibilities and timing
• VISUALISATION BOARD
  Introduction of a visualisation board so that project status is visible to all and in a glance

Results

• Operations undertaken within 18weeks rose from 35% to 88%
• Patient cancellations reduced by 30%, overall cancellations reduced by 7%
• Consistency of operation start times improved by 20%
• Inpatients waiting for treatment above 11 weeks decreased by 97%
• Average start time reduced from 09.20 to 08.50, generating 30minutes of additional time to the Theatre day
• Due to effective scheduling, reduced the amount of changes made to the Theatre list & Won the accolade of "Best Theatre"