GOtheatre Project

A novel approach to optimising utilisation and improving efficiency of theatre lists.

MPH Gynae Oncology Pathway 1: Outpatients & POAC
Patient added to S drive spreadsheetpatient either given a date and told a date is pencilled in, or tell patient cant give a date yet CNS may take the patient to POAC ? Laporoscopic Direct Referrals from other services (5-10%) WLC with information re procedure etc ? Open (inc vulval work)

Staging 2WW Rapid Access Clinic Referrals

Outpatient appointment

Decision re: surgery

Pink folder for notes

Patient goes to POAC

MDT (Yeovil etc)

Alert Anaesthetist re: risks Cc letter or e-mail

Key Process Non secure systemoccasionally leads to cancellations Check access Cons, CNS, Theatres, Admissions, ? Anaesthetists ? POAC ? Investigate placing the order direct on Cerner Issue with POAC not having enough info/legibility/ fining it- the procedure info may be in the clerking sheet in notes

Process identified as not robust

Information

Ideas

JP 30/11/11

Overview of the Project

Problem: Frequent unplanned over-runs to theatre lists leading to; Discharge of patients to wards late in the evening. Cancellation of cases due to running out of theatre time. Deterioration of staff morale due to frequent unanticipated late finishes Project aim: Reduce the frequency of unplanned over-runs. Methods: Process Mapping - Exercise to determine patient flow pathway. Areas for potential improvement identified. Rapid improvement interventions. Wider plan focusing on improving theatre time utilisation. Partnership with staff and student from Manchester Business School - Use novel statistical techniques to track and improve patient flow and thus efficient use of operating theatre lists.

Information Technology Computer systems not user friendly leading to poor quality data collection. Data retrieval and analysis proved complicated and time consuming. Information governance issues around data release.

Results
Project progress Several rapid changes implemented quickly eg Solving technical problems that were preventing surgeons completing paperwork in theatre. Some changes have been slower to embed - eg Changing the way resources such as the ultrasound machine are allocated and tracked. The project is ongoing. The statistical analysis has been supported by hospital management and will be piloted in one specialty before incorporating into list management of several specialties We are already involved in taking this work beyond our hospital. Personal development Increased knowledge and experience of quality improvement methodology. Improved skills and understanding of psychological aspects of leadership.

Leadership Challenges
Change - Establishing the need and culture for change. Team - Establishing a committed team to work on the project Time - Ensuring that the team had enough time to meet and work on the project. Communication Improving communication along the patient care pathway, between clinic and admission staff, theatre staff and staff working on post-operative wards. It had been difficult for staff members from different areas to discuss ideas through current channels.

Contact Information Abigail Hine Specialty Registrar in Anaesthesia abigail.hine@gmail.com 07940 077228