Case study: Theatre Quality Improvement Programme

Improving perioperative patient experience and flow while delivering quality and value improvement.

RCSI’s experienced process improvement advisors with strong engineering and clinical backgrounds provided facilitation, training and support to the participating university hospital team.

Together the multidisciplinary team, including nurses, HCAs, surgeons, anaesthetists, porters and administration designed and implemented significant improvements in the patients journey while optimising the use or their facility and resources.

Objectives

  • Create capacity through value improvement – target utilisations improvement of 10 pct points
  • Improve patient experience and outcomes
  • Improve the safety, quality and reliability of care
  • Team performance and staff wellbeing
  • Develop organisational improvement capabilities. 

Results

The team achieved significant results:

  • Solution identified and implemented for site #1 risk
  • Theatre utilisation increased in 32% on baseline performance in obstetrics and gynaecology theatres
  • Theatre utilisation increased 15% overall on all elective theatres
  • Improved patient flow
  • Capacity created to carry out more surgeries
  • Annualised productivity saving of €734,000
  • Perioperative team trained in improvement
  • Better teamwork
  • Less overruns, happier staff and patients
Theatre Quality Improvement Programme Before After
Start times  May 2017: 15%  December 2017: 80%
Pre-admission  June 2017: 75%  December 2017: 98%
Theatre list submitted on time  July 2017: 50%  December 2017: 100%
Recovery hypothermia  September 2017: 47%  October 2017: 0%
Theatre utilisation (obstetrics and gynaecology)  April 2017: 56% October 2017: 64%
March 2018: 74%
18 pct points 
All elective utilisation (T&O), GS, ENT, OBS/GYNAE  April 2017: 66%  March 2018: 76%  10 pct points