An evaluation of elective orthopaedic operating theatre efficiency at a South African tertiary hospital

Hylda Makanisi; Thenjiwe Hlongwane; Toms Lushiku; Kena  Mogotsi

doi:10.51168/sjhrafrica.v5i12.1470

Authors

Dr Hylda Makanisi University of Witwatersrand
Dr Thenjiwe Hlongwane University of Witwatersrand
Dr Toms Lushiku University of Witwatersrand
Dr Kena Mogotsi University of Witwatersrand

DOI:

https://doi.org/10.51168/sjhrafrica.v5i12.1470

Keywords:

Theatre utilisation, Day of surgery cancelation rate, Operating theatre efficiency, Orthopaedic procedures, south africa

Abstract

Background: The demand for elective orthopaedic surgery has increased in South Africa (SA) due to an increasing burden of trauma and financial constraints caused by a poorly performing economy, highlighting the importance of orthopaedic operating theatre (OT) efficiency in this resource-constrained country. This study aimed to assess the efficiency of elective orthopedic OTs at an SA tertiary hospital.

Methods: This was a cross-sectional study of elective orthopedic OT lists over 8 weeks at Chris Hani Baragwanath Academic Hospital (CHBAH), SA. Data assessed during the study included sub-specialty, number of scheduled and completed cases, time OT commenced activities, time OT ceased activities, case time, turnover time, raw theatre utilization, and day-of-surgery cancellations. The data was analyzed with descriptive statistics.

Results: A total of 117 OT lists equating to 342 cases were included from different orthopaedic subspecialities. The total available OT time was 58331 minutes, of which a large majority, 46638 minutes (80%), was used as case time during conventional OT working hours (95.4%). Fifty-three percent of OT lists started early whereas 29.9% started late, 65% of them underran and 30% overran. The overall raw theatre utilization was 83.0% (range: 71.8-88.2%, SD 16.3) with a DOSC (day of surgery cancelation) rate of 19%.

Conclusion: Overall elective orthopaedic OT utilisation was efficient at CHBAH. The challenge posed by canceled surgeries in CHBAH must be addressed as facility-related reasons were cited as the main reason for cancellations, this will further improve the orthopedic OT efficiency in this hospital.

Author Biographies

Dr Thenjiwe Hlongwane, University of Witwatersrand

Senior anaesthesiology consultant at Chris Hani Baragwanath Academic Hospital and in private practice.

Dr Toms Lushiku, University of Witwatersrand

Anaesthesiology consultant in private practice, Johannesburg, South Africa.

Dr Kena Mogotsi, University of Witwatersrand

Anaesthesiology consultant and intensive care fellow at Chris Hani Baragwanath Academic Hospital

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