63 Introducing The Productive Operating Theatre (TPOT) programme in urology theatre suites

63 - Introducing The Productive Operating Theatre (TPOT) programme in urology theatre... Page 1 of 2

e63 Introducing The Productive Operating Theatre (TPOT) programme in urology theatre suites 1

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Ahmed K. , Khan N. , Anderson D. , Watkiss J. , Challacombe B. , 1

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Khan M.S. , Dasgupta P. , Cahill D. 1

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Guy's Hospital NHS Foundation Trust, Dept. of Urology, London,

United Kingdom, United Kingdom

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King's College London, Medical School, London,

INTRODUCTION & OBJECTIVES: Operating theatres are costly resources in healthcare institutions, encompassing a stressful work environment where patient safety is paramount. Effective communication, organisation and teamwork are essential in running a safe and productive operating theatre. The productive operating theatre (TPOT) is a module based programme designed by the National Health Service to improve value/efficiency, teamwork, patient experience, staff well-being and the safety and reliability of care in operating theatres. The aim of this investigation is to evaluate the effectiveness of introducing TPOT in urology operating theatres and to identify obstacles to running an ideal operating list. MATERIAL & METHODS: TPOT was introduced in two urology operating theatres in September 2010. The whole multidisciplinary team have been involved in “vision workshops” where members of staff have identified obstacles to running the ideal operating list. “Measures workshops” were also conducted to identify further obstacles by auditing and collecting data on certain measures. To improve communication and efficiency in the operating theatre, the “teamworking” module was introduced with a daily briefing and debriefing conducted during every procedure. The “well organised theatre” module was introduced to tackle problems in the standardisation and location of equipment. To identify challenges and to measure the impact of the intervention, theatre session start time and monthly overrun performance was measured following the initiation of TPOT in

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e63a September 2010 to June 2011, during which 1365 patients underwent surgery. Patient satisfaction questionnaires were distributed to 54 postoperative patients returning for follow up. RESULTS: Start/Finish Times: There was a 39-41% increase in the percentage of operating lists starting on time and a £3,030 reduction in total monthly cost of delay (based on overhead costs) from September 2010 to June 2011, involving 1365 cases. Patient experience: 54 urology patients returning for follow were surveyed. Positive comments regarding waiting times (71%), staff communication (60%) and pain management (62%) were found. Negative comments included lack of privacy in the surgical admissions lounge (28%) and level of pain (20%). Staff Well-Being: High positive mean scores from a safety attitudes questionnaire were found: 70% for job satisfaction, 68% for teamwork and safety climate. Recovery: continued delays with 7-18% of patients waiting over 1 hour to be transferred or collected from recovery. CONCLUSIONS: The introduction of TPOT has helped identify obstacles to running the ideal operating list and shown improvements in efficiency measures such as start/finish times and has shown positive patient and staff feedback. Further obstacles include delays in recovery and improving some aspects of patient experience.

file://F:\RamShankar\April\04-05-12\Cip\Sour\63.html

4/7/2012