Towards improved theatre efficiency: a study of procedural times for common elective surgical procedures at Tygerberg Hospital

Abstract

Background: In many hospitals, theatre slates are booked according to potentially inaccurate estimations of procedural times. Furthermore, inaccurate time predictions can contribute towards suboptimal utilisation of theatre time. This study was conducted to evaluate theatre procedural time parameters and predictions. The objectives were to determine the average duration of common elective surgical procedures at Tygerberg Hospital (TBH) and to determine whether there are discrepancies between the estimated procedural times and the actual procedural times for selected common surgical procedures.

Methods: We performed a single-centre retrospective observational study, analysing data from January to December in 2019, obtained from electronic theatre records. A total of 32 elective procedures were examined for total procedural, surgical, and nonsurgical times. Additionally, we prospectively compared the durations of the five most frequent procedures with their estimated times to assess discrepancies.

Results: The time parameters of the 32 common elective surgical procedures performed at this institution were recorded. The cohort was further divided into minor and major surgery groups. The average mean non-surgical time for minor and major surgery was 36 and 44 minutes, respectively. Prospective data analysis showed a statistically significant underestimation of procedural time when compared to the actual duration of total abdominal hysterectomy (p = 0.011), total hip replacement (p < 0.001), transurethral resection  of the prostate (p < 0.001), and above knee amputation (p = 0.013). The average procedural time underestimation for the four procedures ranged between 33% and 61%.

Conclusion: Our study showed that procedural times of selected common elective procedures are frequently underestimated at our institution. This study also collected data that can assist with improving the accuracy of procedural time estimations at TBH, potentially improving theatre efficiency.