Student Dissertation

Agency : Hospital Management; Operation Theatre; Time Utilization; Utilization of Operation Rooms

Objective : Aim of the study: To perform a thorough and step-by-step assessment of operating rooms (OR) time utilization, with a view to assess the efficacy of our practice and to identify areas of further improvement. Objectives of study: To examine the time utilization & scheduling of operation theatre. To identify the bottle necks, if any, in proper and efficient utilization of Operation Theatre time. To suggest remedial measures for improving the Operation Theatre time Utilization.

Background : Utilization ratio analysis is an important part of hospital operations which has been a priority area for hospital administrators. Operation theatres are popularly known as the ‘heart of hospital’. Utilization analysis of Operation theatres is essential to improve the efficiency of operation theatres and to decide about augmentation or downsizing of the theatre facility. This utilization analysis varies in different hospital and healthcare settings. Optimum utilization of the OT complex does not only reduce cost of operations but also increases revenues. Present case study aims at measurement of utilization of Operation Rooms, pre and post-operative Recovery areas of OT complex and identification of bottlenecks needed to be removed for the optimum utilization of operation theatre. This study is a prospective study. The variables chosen were the scheduled time of surgery in OT-List, exact time of surgery, total time spent in pre-op recovery, time for which patient was inside the operating theatre and the total time spent in post-op recovery area. The data was collected, compiled and analyzed. The study concluded that: i) The utilization of OT complex can be optimized by increasing the total timing of operations of Operation rooms by functioning in two shifts and performing minor procedures in minor operation theatres of the OPDs ii) The main bottlenecks include the non-availability of the Operating Room Manual and non- adherence to OT Schedules.

Methodology : Study type: A descriptive study was carried out from 1st March to 30th April 2015. Utilization of each of O.Ts was calculated. Area and Period of Study: The study was carried out in Operation Theatre Complex located on the third floor of the Hospital in a time period of 60 days Sampling: Convenience sampling Data collection: • Primary data source: By direct observation of the processes and discussion with the staff and team members. • Secondary data source: Review of O.T registers

Findings : • There should be a theatre’s users committee with a set of rules and responsibilities. • There should be a policy document for operation theatre that should be reviewed regularly. • Management Information to use theatre resources efficiently and effectively. • Hospital should consider making use of analysis and measures of theatre utilization as a starting point for benchmarking. • First case should reach O.T. in time from the ward, to allow the O.T. to be started on time. • Perform all the minor procedures in minor O.T.’s attached to the OPD. • The first case to be done in OT must be In-house so that delay because of late admission of the patient in the hospital can be avoided. • More trolleys are needed to shift the patients in and out of M.O.T. Complex. • The Anesthesia and other equipment must be made ready by the assisting staff so that the O.T. starts on time.

Recommendations : The utilization time of existing OT complex is 72% and the maximum possible OT utilization by global standard ranges from 85% to 90%. So, there is a gap of 13% to 18%. This gap is due to delay of approximately 1 hour in OT timings in the existing setup. The major reason for this delay can be attributed to TPA cases in which approval is required in orthopedic cases. So, the gap can be fulfilled i) by scheduling TPA orthopedic cases properly and ii) by increasing the shifts from 2 to 3.