Student Dissertation

Agency : Operation Theatre; Utilization of OT

Objective : To study utilization of OT in Sarvodaya hospitals.

Background : In today’s world people are becoming more and more cautious towards health services. The managerial aspect of providing health services to patients in hospitals are becoming increasingly important. An operation theatre is one key area of the hospital where live saving and life curing procedures are carried out under aseptic conditions in a controlled environment by specially trained personnel with proper handling, comfort to patients ensuring maximum safety. In any hospital, the OT is said to be the primary source of revenue generation with around 50-60 percent of revenue earned just by this area. It is therefore desirable to optimize the efficiency of these assets. The efficiency of operating theatres can be measured in a variety of ways. Essentially it tends to be defined in terms of ability to translate available time into earnings. Utilization is a simple and adequate measure of the efficiency of a theatre, because its ability to generate revenue (its efficiency) rises as the time for which it is used increases OT utilization is defined by Donham and colleagues as the quotient of hours of OT time actually used during elective resource hours and the total number of elective resource hours available for optimum utilization. OT time has always been a priority area for Hospital Administrators. Baker had opined that accurate records, weekly analysis of recorded data, establishment of operating room rules and regulations and strict adherence to and enforcement of approved policies and procedures are essential ingredients for an efficient operating of an operating room. It can be inferred that utilization of OT in the institute is optimum, except for IDOT complex. The reason can be explained by the difference of scheduling surgeries in the theatres. Due to open scheduling, many times theatre tables are under booked for surgeries by the department. It can be noted that utilization of theatre by various departments is also optimum, except for the departments of vascular surgery and cardiothoracic surgery. This was mainly due to underestimation of time consumed by each surgery resulting in cancellation of surgeries posted last in list, leading to unutilized time at the end of the day in Operation Theatres. Such arguments are, however, potentially flawed, mainly because durations of surgical operations cannot be predicted with certainty and the impact of complications that may arise cannot be ignored. Although utilization measured longitudinally may be characteristic, utilization would typically vary from day to day, depending on caseload and the individual nature of procedures.

Methodology : Data Collection Tool Template was constructed keeping in mind the study objectives as well as the available variables in the OT register, reporting month, OT number, duration of the surgery (OT in time and out time), OT wise surgeries , total number of surgeries. Data Collection Method Secondary data Data was collected every day from the OT register with the help of a preformed template which is attached in the annexure. All surgeries performed in 6 OT’s over the period of 3 months were taken. As per hospital protocol the working hours for the OTs are from 7a.m. to 8p.m. i.e. 13hours. OT preparation time was taken as 30 mins as per the availability of nursing staff and anesthetist. Standard days for February, march, April are 24, 25, 26 respectively. The details of the OT record register-name, IP no. age, anesthetist, type of anesthesia, surgeon in and out time and staff and surgery code, procedure done, OT planned, OT done.

Recommendations :The trend of OT 1 has been found to increase from February to April month by 18%. Similarly, utilization in OT 3 & 4 has seen an abrupt change from 59% to 80% and nearly to 84% from 45% respectively. OT 4, OT 5, OT 6 shows a plateau stage over a period of 3 months.