Audit of operating theatre time utilization in neurosurgery

Utilization of operating theatre time is an important issue in neurosurgery, in a National Health Service Hospital. NHS Trusts are under ever increasing pressure to meet specified 'targets' in relation to admissions and operations. We performed a retrospective audit on the utilization of neurosurgical operating theatres at Royal Preston Hospital, analysed the times required for various common neurosurgical operations, and broke them down into clinical (operating and anaesthetic) and non-clinical times. We have also looked at the adequacy of available theatre sessions, and the under or over-running of available theatre sessions. A detailed time-based evaluation of 810 procedures over a 16-month period is presented. The mean and 80th centile of the time taken for anaesthesia, surgery and other non-clinical activities are described along with the total time spent in theatre for common neurosurgical procedures. The mean times for transit, preparation for anaesthesia, preparation for surgery, recovery in theatre and time between cases were 16, 13, 14, 15 and 8 minutes, respectively. The mean time duration between the end of one surgical procedure and the beginning of the next was 101 minutes. It was found that actual operating time was surprisingly only 56% of the time available. These data could be used to schedule operating theatre sessions for neurosurgery in the UK, as we believe our practice to be representative of a majority of units in the country.