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

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Session Details

Session Title: Presented Poster Session: FLACS & Others

Venue: Poster Village: Pod 1

First Author: : H.Roberts UK

Co Author(s): :    J. Myerscough   S. Borsci   M. Ni   D. O'Brart     

Abstract Details

Purpose:

To provide a quantitative assessment of cataract theatre lists with a focus on productivity and staffing levels/tasks using time and motion studies.

Setting:

The five institutions studied were the BMI Southend Private Hospital, Norfolk and Norwich NHS Foundation Trust, Guy’s & St Thomas’ NHS Foundation Trust, Southend University Hospital NHS Foundation Trust and West Suffolk NHS Foundation Trust.

Methods:

National Health Service (NHS) cataract theatre lists were prospectively observed in 5 different institutions (four NHS hospitals, one private hospital). All operations were performed by a consultant or associate specialist. Individual tasks and their timings of every member of staff were recorded. Multiple linear regression analyses were performed to investigate possible associations between individual timings and tasks.

Results:

Data were recorded for 119 operations over 16 four hour theatre sessions. The median number of individual cataract operations per session was 6 (range 5 - 13). The average time to perform a cataract operation was 10.48minutes (min) and to complete one case including patient turnaround was 20.58min. A multiple linear regression model found a significant association with an R2=0.47 between the time to perform one operation and three factors, namely: the number of allied health professionals (AHPs) and the number of key tasks performed by the AHPs and the time taken to perform these key tasks by the AHPs.

Conclusions:

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. By supporting the surgeon with sufficient AHPs, surgical efficiency can be improved. Adoption of high volume cataract surgery models could deliver approximately double productivity over conventional theatre models.

Financial Disclosure:

NONE

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