Theatre delay for general surgical emergencies: a prospective audit

Area of Science:

• Surgical Services Management
• Healthcare Operations Research
• Emergency Medicine

Background:

• Emergency theatre use in general surgery is critical for timely patient care.
• Delays in emergency surgical procedures can negatively impact patient outcomes.
• Optimizing theatre scheduling is essential for efficient hospital operations.

Purpose of the Study:

• To evaluate the impact of a fully staffed 24-hour emergency theatre on general surgery operations.
• To assess changes in the timing and duration of emergency surgical procedures.
• To identify and address delays in the provision of emergency surgical care.

Main Methods:

• Prospective audit of emergency theatre utilization over two-month periods before and after implementing a 24-hour service.
• Data collection included decision-to-operate time, actual operation time, reasons for delay, and delay duration.
• Statistical analysis to compare outcomes between the pre- and post-implementation periods.

Main Results:

• Proportion of procedures performed after midnight decreased significantly (21.3% to 6.3%).
• Emergency operating hours shifted to 0900-1700 hrs, increasing from 29.4% to 61.3%.
• Significant reduction in delay times for appendectomy (median 4h 40m to 1h 29m) and abscess drainage (median 5h 56m to 1h 51m).

Conclusions:

• A 24-hour emergency theatre effectively reduced operating delays for general surgical emergencies.
• The shift in operating times indicates improved efficiency and resource allocation.
• The audit successfully closed the improvement cycle, enhancing care for patients requiring urgent surgery.