ESCRS - FP63 - TIME AND MOTION STUDIES TO ASSESS SURGICAL PRODUCTIVITY IN CATARACT THEATRE LISTS WITHIN THE NATIONAL HEALTH SERVICE: IMMEDIATE SEQUENTIAL BILATERAL CATARACT SURGERY VERSUS DELAYED SEQUENTIAL BILATERAL CATARACT SURGERY.

TIME AND MOTION STUDIES TO ASSESS SURGICAL PRODUCTIVITY IN CATARACT THEATRE LISTS WITHIN THE NATIONAL HEALTH SERVICE: IMMEDIATE SEQUENTIAL BILATERAL CATARACT SURGERY VERSUS DELAYED SEQUENTIAL BILATERAL CATARACT SURGERY.

Published 2022 - 26th ESCRS Winter Meeting

Reference: FP63 | Type: Abstracts | DOI: 10.82333/edhy-am30

Authors: Khayam Naderi* 1 , Chun Fung Jeffrey Lam 2 , Sancy Low 3 , Mani Bhogal 4 , Ashmal Jameel 4 , Korina Theodoraki 4 , Lily Lai 4 , Luis Onrubia Garcia 4 , Harry Roberts 4 , David O'Brart 5

1Ophthalmology,St.Thomas' Hospital ,London,United Kingdom;Diabetes and Nutritional Sciences,King's College London,London,United Kingdom, 2Medicine,King's College London,London,United Kingdom, 3Ophthalmology ,St.Thomas' Hospital ,London,United Kingdom, 4Ophthalmology,St.Thomas' Hospital ,London,United Kingdom, 5Ophthalmology,St.Thomas' Hospital ,London,United Kingdom;Diabetes and Nutritional Science,King's College London,London,United Kingdom

Purpose

 

To compare cataract theatre productivity in the National Health Service (NHS) with back-to-back immediate sequential bilateral cataract surgery (ISBCS) compared to routine case lists consisting of exclusively unilateral cases (UC). 

Setting

Single-centre, prospective, single-masked randomised case-controlled trial in a university hospital. 

Methods

Four 4- hour theatre lists with a minimum of three ISBCS cases (3 pairs of eyes) were observed using time and motion studies. The individual tasks and timings of each staff member in theatre was recorded by two observers. The results were compared to previously recorded data in four 4-hours cataract surgery lists in the same hospital consisting of only UC. All operations were performed by consultant surgeons.

Results

 

The median number of eyes operated per 4-hour list in the ISBCS group was 7.25 compared to 5.75 eyes in the UC group (p=0.032). The median total theatre time (defined as time between the entry of the first patient and the exit of the last patient from theatre) was 130.20 minutes in the ISBCS group and 177.90 minutes in the UC group (p=0.20). The median patient turnover time was 8.70 minutes in the ISBCS group and 15.88 minutes in the UC group (p=0.0001). 

Conclusion

Performing back-to-back ISBCS on routine surgical lists appears to increase surgical productivity within the National Health Service. Time and Motion studies are a useful way to investigate surgical productivity and test theoretical models for efficiency improvements.