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Is theatre utilization a valid performance indicator for NHS operating theatres?

Omar Faiz¹, Paris Tekkis, Alistair McGuire

¹Department of Surgery, St Mark's Hospital, Harrow, Middlesex, HA1 3UJ, UK. omarfaiz@aol.com

BMC Health Services Research

|February 2, 2008

Summary

Operating theatre utilization in the NHS is influenced by list size and overruns, not surgeon performance. While it can indicate administrative issues, it

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Area of Science:

Healthcare Management
Surgical Operations Research
Health Services Research

Background:

Operating theatre utilization is a key metric for National Health Service (NHS) theatre performance.
This study evaluates its effectiveness as a management tool, an inter-hospital efficiency indicator, and a measure of surgeon service performance.

Purpose of the Study:

To assess the validity of theatre utilization as a performance indicator in the NHS.
To identify key factors influencing theatre utilization.
To determine if utilization accurately reflects surgeon service performance.

Main Methods:

A multivariate linear regression model was applied to seven years of elective general surgery operating list data from an NHS Teaching hospital.
Factors analyzed included operating list size, surgeon/anaesthetist influence, late starts, overruns, session type, and theatre suite.

Main Results:

The strongest predictors of operating list utilization were list size (p < 0.01) and list overruns (p < 0.01).
While surgeons' impact on utilization varied, their overall influence was minimal.
7,283 inpatient and 8,314 day case operations were analyzed.

Conclusions:

Theatre utilization generally correlates with the volume of elective surgeries performed.
Extreme utilization values may signal administrative failures within trusts but are not specific enough for inter-trust comparisons.
Unadjusted utilization rates do not accurately represent surgeon service performance due to limited surgeon influence.