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A predetermined first patient on the trauma list can improve theatre start times
Saqib Javed1, Chris Peck, Debbie Salthouse
1Department of Trauma and Orthopaedics, Royal Preston Hospital, Sharoe Green Lane, Preston PR2 9HT, UK.
Insights
Implementing the golden patient (GP) strategy significantly improved trauma theatre start times. This initiative enhances surgical theatre efficiency by ensuring the first patient is medically fit with a clear surgical plan.
Area of Science:
- Trauma Surgery
- Operating Room Management
- Healthcare Efficiency
Background:
- A busy teaching hospital introduced the golden patient (GP) concept in April 2009.
- The GP is a pre-selected, medically fit patient with a clear surgical plan for the next day's trauma list.
- The primary aim was to improve trauma theatre start times.
Purpose of the Study:
- To evaluate the impact of the golden patient initiative on trauma theatre start times.
- To compare theatre start times before and after the implementation of the GP strategy.
Main Methods:
- A prospective study design was employed.
- Trauma theatre start times were compared over two two-month periods: one before the GP introduction and one after.
- A two-sided t-test was used for statistical analysis.
Main Results:
- The golden patient was designated on 76% of planned trauma lists and remained first on the actual list 88% of the time.
- Mean operation start time improved from 10:03 AM before GP implementation to 09:33 AM with the GP strategy (P<0.001).
- No statistically significant differences were observed in reception or anaesthetic start times, indicating the GP strategy was the cause of improved operation start times.
Conclusions:
- The introduction of the golden patient strategy has led to a significant improvement in trauma theatre start times.
- This initiative enhances overall surgical theatre efficiency.
Introduction:
The concept of the golden patient (GP) was introduced to our busy teaching hospital, in April 2009, with the aim of improving our trauma theatre start times. The GP is a pre-selected first patient on the following day trauma list who is medically fit with a clear surgical plan.
Methods:
This prospective study compared the trauma theatre start times over a two month period following the introduction of the GP, with a similar two month period prior to the introduction of the GP. A two-sided t-test was used to evaluate statistical significance between groups.
Results:
Of the 55 planned trauma lists analysed, 42 had a designated GP on it (76%), 37 of which remained first on the actual trauma list (88%). The mean operation start time for the pre-GP lists was 10:03 compared to 09:33 for the actual GP lists (P<0.001). The reception, anaesthetic and operation start times for pre-GP lists compared with lists where no GP was selected were not statistically significant suggesting that the GP was the cause of the significance.
Conclusion:
The introduction of the GP to our trauma lists has made a significant improvement to theatre start times and consequently surgical theatre efficiency.
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