operating theatre efficiency guidelines · background: 270 ots in 99 public hospitals across nsw in...
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Operating Theatre Efficiency Guidelines
Friday 30th October 2015
Gavin Meredith, SST Manager, ACI Phyllis Davis Nursing Director , POWH, SST member
Operating Theatre Efficiency Guidelines
Background
Principles for metric selection
Using metrics to uncover inefficiencies
Metrics for Activity, Efficiency & Safety
Management of the OT
Operating Theatre Efficiency Guidelines Background:
270 OTs in 99 public hospitals across NSW
In 2011–12, c. 210,000 patients had elective surgery
45% of all public hospital admissions Estimated to cost c. $1.3 billion each year About 17% of NSW Health’s inpatient services
budget.
Operating Theatre Efficiency Guidelines
“Linking funding to efficiency, and giving hospitals the tools and motivation to
improve, can free up a billion dollars each year.”
Grattan Institute (2014)
Auditor-General Report, Operating Theatre Efficiency
Key Findings: • OT’s can be managed more effectively • Wide performance variation across NSW • Targets missed – OT utilisation, cancellation on
day of surgery & first case on time starts • OT managers do not have all the information
required to manage OT efficiently
ACI and MoH Response • Strengthen OT management
• Provide OT managers with required information
• Develop better efficiency measures
• Better understand the capacity of OTs
• Monitor the cost of OTs
http://www.aci.health.nsw.gov.au/__data/assets/pdf_file/0020/287111/ACI_OT_Efficiency_Data_Dictionary.pdf
Operating Theatre Efficiency Guidelines
Background
Principles for metric selection
Using metrics to uncover inefficiencies
Metrics for Activity, Efficiency & Safety
Management of the OT
Principles for Metric Selection
Is the metric available?
Is the metric relevant?
Is the metric actionable?
Principles for Metric Selection
Principles for Metric Selection
Ideal OT dashboard: • Aligned to the overall objectives of the OT suite/hospital • Provides accurate & objective data • Displays information visually - outlier trends and variances easily determined • Presents data that is real time as required • Presents a logical hierarchy of information with drill down capability • Internet or intranet-based for timely accessibility
SST Dashboard
Operating Theatre Efficiency Guidelines
Background
Principles for metric selection
Using metrics to uncover inefficiencies
Metrics for Activity, Efficiency & Safety
Management of the OT
Using Metrics to uncover Inefficiencies
Using Metrics to uncover Inefficiencies
First Case on time start
Operating Theatre Efficiency Guidelines
Background
Principles for metric selection
Using metrics to uncover inefficiencies
Metrics for Activity, Efficiency & Safety
Management of the OT
OT performance indicators and measures Determination Indicator/me
asure Target
% patients treated on time (Cat 1, 2 & 3)
KPI 100%, 97% and 97%
Overdue patients (Cat 1,2 & 3) KPI 0,0,0
Theatre Utilisation KPI 80%
% FCOTS Measurement % & average time late start
Theatre Attendances Measurement
% cancellations on day of surgery KPI <2%
DOSA KPI 90%
Operating Theatre Efficiency Guidelines
Background
Principles for metric selection
Using metrics to uncover inefficiencies
Metrics for Activity, Efficiency & Safety
Management of the OT
Leadership roles in the OT
Recommendations for the management of internal influences
• Establish a ‘Floor Coordinator’ role as the single point for daily OT coordination
• Ensure the right staffing and skill mix • Develop rosters that match activity • Develop an operating theatre session template
External influences on operating theatre efficiency
Self Assessment
OT Cost template
http://www.aci.health.nsw.gov.au/resources/surgical-services/efficiency/operating-theatre-costs.xlsx
In summary
1. Broad range of indicators 2. Drill down into the detail 3. Share the results 4. Ask for assistance or share your results
Level 4, Sage Building 67 Albert Avenue, Chatswood NSW 2067 PO Box 699 Chatswood NSW 2057
T + 61 2 9464 4666 F + 61 2 9464 4728
[email protected] www.aci.health.nsw.gov.au
Gavin Meredith Surgical Services Taskforce Manager
02 9464 4644 [email protected]
Level 4, Sage Building 67 Albert Avenue, Chatswood NSW 2067 PO Box 699 Chatswood NSW 2057
T + 61 2 9464 4666 F + 61 2 9464 4728
[email protected] www.aci.health.nsw.gov.au
Phyllis Davis Nursing Director Operating Theatres
Prince of Wales Hospital 02 9382 4209