Audit of operation theatre utilization in general surgery

Abstract

Background: The operation theatre complex of a hospital represents an area of considerable expenditure in a hospital budget and requires maximal utilization to ensure optimum cost-benefit. There is paucity of data in India on the use of available operating time and the reasons for less-than-optimal utilization have not been studied.

Methods: This audit was done prospectively over a period of 12 months in the department of general surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry. Operation theatre utilization was studied with respect to the starting and closing of the operation theatre, interval between surgical procedures, cancellation of surgical procedures and reasons thereof.

Results: The operation theatre was functional for 279 days during the year of the study, and 1773 cases were operated (6.3 cases per day). The total operating time utilized was 91.5%. The major reasons for cancellation of a total of 310 cases were lack of operating time (65.2%), emergency surgery during the elective list (13.9%), and preoperative lack of fitness (11.3%). Among all the lists, 43.6% started late and 63.6% of lists finished well before the scheduled closing time. Absence of monitoring equipment and non-availability of additional qualified anaesthetists necessitated induction of anaesthesia in the main operating room and accounted for 11% of the total operating time.

Conclusion: Delay in starting lists, under-scheduling, interruption due to emergency surgeries, administrative reasons, induction of anaesthesia and recovery policies are the main factors that account for inefficient use of operating facilities. The correction of these factors would increase the available operating time by nearly 20%.