Can we make better use of our operating theatres?

Abstract

Abstract Background The utilisation rate of operating theatres is one of the indicators of efficient management in a Hospital. Our analysis focuses on the percentage of room utilization for planned activity. The aim is to compare the results of the manual planning carried out by the Surgical Scheduling Office (SSC) with the one carried out automatically by the testing of a Decision Support System (DSS) management application based on the automatic analysis of factors involved in the creation of surgical scheduling. Material and Methods The study took place at the Hospital ‘Alta Valdelsa’ in Poggibonsi, Tuscany, Italy. It first saw the collection and cataloguing over a period of one month (Nov 2022), for each speciality, of the operating notes made by the SSC, taking into consideration the indications of the respective referring surgeons. From the surgical work pathway management system (ORMAWEB), the actual average operating times over the same period were then collected for each specialty. Finally, for comparison, the DSS worked out the best room scheduling according to an algorithm based on waiting lists, priorities, and operator surgical times. Results Following the manual planning of 143 scheduled operations, the planned utilization of the operating theatres was in most cases confirmed by the reality of the occupied room times extrapolated from ORMAWEB, with slight differences due to patient-dependent modifications. Out of a total of 350 hours available for surgical specialties, the manual operating notes predicted room occupancy for only 196 hours and 40 minutes, with a utilization rate of 56.3%. The DSS application, on the other hand, produced a possible schedule with a room occupancy of over 90%. Conclusions The study shows that the efficiency of the operating theatre could be significantly increased if the SSC were supported by a DSS application that uses totally objective criteria in the selection of patients to be operated on the waiting list. Key messages • The use of new applications in surgical path management can improve the efficiency of the operating theatre. • Increased utilisation of surgical rooms results in better rationalisation of available resources of the Hospital.