Influence of COVID-19 Protocols on the Efficiency of Trauma Theater: Retrospective Observational Study

The COVID-19 pandemic has influenced health care delivery significantly. Numerous studies have highlighted that trauma theater efficiency has decreased during the COVID-19 pandemic; however, there is limited information as to exactly which stage of the patient theater journey is causing this decreased efficiency and whether efficiency can be improved. In the trauma theater of Warrington Hospital, United Kingdom, we have attempted to maintain trauma theater efficiency despite the requirement for increased infection control.

The aim of this study was to evaluate the effects of additional COVID-19 infection control protocols on trauma theater efficiency in our center, considering the length of time taken for specific theater events, and to find out whether our interventions were successful in maintaining theater efficiency.

We compared the efficiency of the trauma theater in a busy unit in December 2019 (pre-COVID-19) and December 2020 (with COVID-19 protocols in place). We collected time logs for different theater events for each patient in December of both years and compared the data.

There was no significant difference in the average number of cases performed per session between the COVID-19 and pre-COVID-19 time periods (P=.17). Theater start time was significantly earlier during the COVID-19 period (P<.001). There was no significant difference between the two periods in transport time, check-in time, preprocedure time, anesthetic time, and the time between cases (P>.05). A significant difference was observed in the check-out time between the two groups in the two time periods, with checking out taking longer during the COVID-19 period (P<.001).

Our results show that our theater start times were earlier during the COVID-19 pandemic, and the overall theater efficiency was maintained despite the additional COVID-19 infection control protocols that were in place. These findings suggest that well-planned infection control protocols do not need to impede trauma theater efficiency in certain settings.