An investigation into the utilisation of available emergency theatre time at a tertiary academy hospital in South Africa

Abstract

Background: The rising global health burden from non-communicable diseases and injuries requires effective surgical care. South Africa struggles with this due to resource limitations. Efficiently managed theatres provide financial benefits, improve operational efficiency, boost staff morale, and ensure high-quality healthcare. The lack of comprehensive South African literature on emergency theatre efficiency worsens the underutilisation issue in public theatres nationwide.
Methods: This study was conducted at Tygerberg Hospital (TBH), a tertiary hospital in Parow, Western Cape. It houses two general emergency theatres shared between all surgical disciplines, excluding orthopaedics and obstetrics. A retrospective audit of the emergency theatre registry was conducted for all surgical procedures performed over six months. Our analysis focused on start and end times for both anaesthesia and surgery to assess theatre utilisation (TU) and turnover times (TOT) between cases.
Results: A total of 1 663 surgical procedures were performed in two general emergency theatres over 181 days. The TU rate was 53.58%. The average TOT between consecutive cases was 2.51 hours. Total surgical time (TST) only accounted for 33.86% of the total theatre time utilised. Among the surgical specialities, neurosurgery emerged as the leading field, accounting for 23% of all cases performed.
Conclusion: This study explores the utilisation of emergency theatre time at a tertiary institution in South Africa. Our findings offer valuable insights into the distribution and demand patterns for emergency theatre time across various surgical disciplines, highlighting overall TU and TOT for emergency cases. The results reveal a significant gap in available theatre hours and actual usage, identifying a critical area of inefficiency with considerable potential for improvement.