‘Golden Patient’: A quality improvement project aiming to improve trauma theatre efficiency in the Royal Gwent Hospital

Key, Thomas Martin; Reid, Gavin; Vannet, Nicola; Lloyd, John; Laurent, David Burckett-St

doi:10.1136/bmjoq-2018-000515

Cited by 10 publications

(17 citation statements)

References 8 publications

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“…Over recent years, even before the COVID-19 pandemic, much research had been undertaken to investigate ways to optimise the expensive asset of trauma theatres. The concept of a golden patient is often championed as a potential solution [ 17 - 18 ]. The promise is that a prompt start will result in a more efficient list and is more important in these times than ever before.…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 Pandemic on Trauma Theatre Efficiency

Khadabadi¹,

Logan²,

Handford³

et al. 2020

Cureus

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Introduction A large transformation in the management of trauma has ensued following the COVID-19 (coronavirus disease 2019) pandemic. There has been an increase in reliance on guidance for decision-making and alterations in the working of the trauma theatre. This has largely been due to the safety measures implemented. Theatre efficiency has gained increasing importance over the years, and with the added pressure of the pandemic, it is essential that trauma theatres operate efficiently. There has been no data analysing the efficiency of trauma theatre during this pandemic. Methods and Results We retrospectively analyzed the data at our hospital and looked into the parameters to assess trauma theatre efficiency. It was noted that the operative time and anaesthetic time went up significantly in 2020 in comparison to 2019. Also, the change over time and the late start time was significantly high in 2020. A large proportion of cases did not start on time in 2020. This resulted in a decrease in the efficiency of theatre usage. Discussion Reduced productivity of the trauma theatre has been due to several reasons, many of which include implementation of safety measures, such as personal protective equipment (PPE), theatre cleaning, recovery of patients, using designated routes for transfer, and many others. The challenge lies in applying these new measures into our daily practice at the same time while providing efficient care. Conclusion Our study highlights the key areas of concern and improvement which need to be addressed in order to render effective trauma care.

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Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 Pandemic on Trauma Theatre Efficiency

Khadabadi¹,

Logan²,

Handford³

et al. 2020

Cureus

View full text Add to dashboard Cite

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“…The comparative mean reception times between weekdays and weekends for the audited period including the 95% CI for the population mean were also evaluated. The mean reception time for weekdays was 09:06, and for weekends, it was 09:14 the most commonly chosen parameter to determine GPI efficacy [9,17,[20][21][22][23][24][25][26][27][28][29]. The number of theatre case cancellations was measured in three studies [17,20,22] while changes to total case numbers were also examined in three studies [20,22,25].…”

Section: Resultsmentioning

confidence: 99%

The Golden Patient Initiative: A Systematic Review

Khan¹,

Azam²,

Elbayouk³

et al. 2023

Cureus

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Operating theatres and surgical resource consumption comprise a significant proportion of healthcare costs. Inefficiencies in theatre lists remain an important focus for cost management, along with reducing patient morbidity and mortality. With the emergence of the coronavirus disease 2019 (COVID-19) pandemic, the number of patients on theatre waiting lists has surged. Hence, there is a pressing need to utilise the already limited theatre time and fraught resources with innovative methods. In this systematic review, we discuss the Golden Patient Initiative (GPI), in which the first patient on the operating list is pre-assessed the day prior to surgery, and we aim to assess its impact and overall efficacy.A literature search using the following four databases was conducted to identify and select all clinical research concerning the GPI: Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Excerpta Medica Database (EMBASE), and the Cochrane library. Two independent authors screened articles against the eligibility criteria, using a process adapted from the Preferred Reporting Items for Systematic Reviews and Metaanalyses (PRISMA) guidelines. Data extracted included outcomes measured, follow-up period, and study design. The results showed significant heterogeneity, and hence a narrative review was conducted; 13 of the 73 eligible articles were included for analysis. Outcomes included delay in theatre start time, number of surgical case cancellations, and changes to total case numbers. Across the studies, a 19-30-minute improvement in theatre start time was reported (p<0.05), as well as a statistically significant decrease in case cancellations. Our analysis provides encouraging conclusions with regard to greater theatre efficiency following the application of GPI, a low-cost solution that can easily be implemented to help improve patient safety and lead to cost savings. However, at present, it is largely implemented among local trusts, and hence larger multi-centre studies are required to gather conclusive evidence about the efficacy of the initiative.

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“…Use of theatre booking forms and identification of a ‘golden patient’ has been shown to improve theatre list efficiency (Key et al 2019, Williams et al 2017). These ‘golden patients’ are suitable patients admitted the previous day and optimised for surgery, prior to the next day’s trauma list, so they can be operated on as the first case on the list to reduce delays.…”

Section: Discussionmentioning

confidence: 99%

Reducing trauma theatre list delays through improved communication between orthopaedic teams and radiographers: A quality improvement project

Anazor

Ekungba-Adewole

Dhinsa

et al. 2023

Journal of Perioperative Practice

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Aims: This quality improvement project was performed to improve delays in starting our trauma theatre lists by implementing measures to improve effective communication between the surgical team and the theatre radiographers. Materials and Methods: This was a quality improvement project performed prospectively for 30 orthopaedic trauma lists over two cycles. Only lists requiring fluoroscopy guidance (image intensifier) for the first case were included. Interventions included improvements in use of theatre booking forms with fluoroscopy request checkboxes, dedication of an allocated radiographer for the trauma lists, timely communication of the finalised theatre list order and radiographers participating in the team briefing. Results: Improvements in the timing of fluoroscopy requests and prompt arrival of the radiographer to the theatre were achieved. Furthermore, there was elimination of radiographer-related surgical start time delays following implementation of the interventions. Nevertheless, only minimal improvements were achieved in the participation of the radiographers for the trauma theatre team briefings. Conclusion: Although reasons for trauma theatre delays are multifactorial, this quality improvement project has demonstrated that these delays can be reduced through improved communication between radiographers and the orthopaedic team. This is especially important for theatre cases requiring the use of an image intensifier.

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‘Golden Patient’: A quality improvement project aiming to improve trauma theatre efficiency in the Royal Gwent Hospital

Cited by 10 publications

References 8 publications

Impact of COVID-19 Pandemic on Trauma Theatre Efficiency

Impact of COVID-19 Pandemic on Trauma Theatre Efficiency

The Golden Patient Initiative: A Systematic Review

Reducing trauma theatre list delays through improved communication between orthopaedic teams and radiographers: A quality improvement project

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