Improving operating theatre efficiency at Sir Charles Gairdner Hospital

More patients have passed through Sir Charles Gairdner Hospital’s (SCGH) operating theatre doors this year compared to the same time last year, following an 18-month large scale clinical service redesign program designed to increase operating theatre efficiency and improve utilisation of their operating theatres. 

In early 2016, the Theatre Efficiency Reform Program (TERP) was initiated at SCGH in response to recommendations released by the Office of Auditor General (OAG) in its November 2015 report, which followed the OAG’s assessment of operating theatre efficiency at five public hospitals in WA Health for delivery of elective surgery from 2009 to 2014.

Extensive communication and consultation was undertaken with key stakeholders to define the TERP scope and the intended deliverables, with participation from a variety of disciplines including nursing, medical, clerical, allied health, technical and patient support services, and input from operational areas such as operating theatres, inpatient bookings, and inpatient wards.

Program Sponsor and Medical Co-Director Surgical Division Dr Jodi Graham said she was highly impressed by staff’s willingness to contribute to the project.

“Close to 150 participants from across many disciplines and departments brought their enthusiasm and solution-focused ideas to the many 6am and 7am workshops,” said Dr Graham.

“Together, we identified nine key solution areas, and for each of these solutions we formed working groups which then did extensive consultation, literature reviews and benchmarking with peer organisations to develop and implement the solutions.

“Some of the solutions included changing the operating theatre schedule to increase the number of elective surgeries flowing through the doors, and revising the process of prioritising emergency patients for surgery so that emergency patients get timely access to theatre.

“The theatre staff also wanted to improve the teamwork culture, and we are moving steadily down this track.”

As at June 2017, SCGH is recording excellent improvements across many of its performance indicators against Department of Health targets:

  • Operating theatres are utilised at 84% (previously 79%) of their capacity (target is 80% utilisation).
  • The median turnaround time between elective surgeries has improved from 11 minutes to 9 minutes (target is less than 15 minutes).
  • More first surgeries of the day are starting on time, 85% versus 69%, (target is 70% elective surgeries starting on time), and 94% of emergency surgeries starting on time, compared to 85% at the same time the previous year (no target for emergency surgeries starting on time).

At the end of the project in June 2017, six of the nine solutions had been completed, with three solutions in progress and in the process of transitioning to a business-as-usual model for ongoing monitoring and reporting. Work is continuing to improve performance across all key performance indicator areas.

The project initiation and diagnostic phases were managed by the Department of Health’s Clinical Support Directorate staff, and project management was handed over to SCGH’s Innovation and Improvement Unit during the solution development and implementation phases.