Time and motion studies of National Health Service cataract theatre lists to determine strategies to improve efficiency

Abstract

Significant variability in the number of cases performed and the efficiency of patient flow were found between different institutions. Time and motion studies identified requirements for high-volume models and factors relating to performance. Supporting the surgeon with sufficient AHPs and tasks performed by AHPs could improve surgical efficiency up to approximately double productivity over conventional theatre models.

Evaluation of a hub-and-spoke model for the delivery of femtosecond laser-assisted cataract surgery within the context of a large randomised controlled trial

“…Furthermore, a minimum of four AHPs may be required to deliver high-volume cataract surgery with effective use of theatre time and minimum delays 21. Our cataract ORs are generally run with three AHPs, which precludes further increases in productivity, which is evident in our turnaround time compared with other surgical units.…”

<p>Efficiency of Operating Room Processes for Elective Cataract Surgeries Done by Residents in a National University Hospital</p>

“…11 Moreover, in a time and motion study of 140 operations across 18 theatre sessions, extreme variability in the number of cases performed, and patient flow efficiency between different institutions was observed. 19 In this study, the average time to complete one case was 19.97 minutes. They also found a significant association between the duration of one operation with the number of allied health professionals (AHPs), leading the authors to conclude that supporting the surgeon with sufficient AHPs could improve operational efficiency significantly.…”

“…They also found a significant association between the duration of one operation with the number of allied health professionals (AHPs), leading the authors to conclude that supporting the surgeon with sufficient AHPs could improve operational efficiency significantly. 19 …”

“…Many studies have pointed out both controllable and uncontrollable factors and strategies that can be adopted to improve efficiency in the operating room. 11,[19][20][21] In a multilevel study comparing the process of cataract surgery in Belgium, process flow was negatively influenced by the severity of the cataract and presence of particular cause variation. On the other hand, the flow was enhanced with topical anesthesia (instead of peribulbar, retrobulbar or general analgesia), surgeons' experience, use of specialized scrub nurses, and eye clinic design.…”

Shaking the usability tree: why usability is not a dead end, and a constructive way forward

“…(Kushniruk and Patel 2004;Borsci, Buckle, and Hanna 2016;Polisena et al 2018). Therefore, usability methods in healthcare are one of the multiple evidence needed to assess services and tools, and to support the adoption of new systems and processes (Green and Mercer 2001;Brown et al 2013;Federici, Meloni, and Borsci 2016;Borsci et al 2017;Roberts et al 2017;Roberts et al 2018). Clinicians, biomedical engineers and experts of health technology assessment are increasingly recognising the importance and demanding for adapted usability methods to evaluate the quality of interaction and its relationship with value and likelihood of technologies' adoption (Huddy et al 2015;Polisena et al 2018).…”