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

Harry W. Roberts (Corresponding Author), James Myerscough, Simone Borsci, Melody Ni, David P.S. O'Brart

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Scopus)

Abstract

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

Methods: National Health Service (NHS) cataract theatre lists were prospectively observed in five different institutions (four NHS hospitals and one private hospital). 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: 140 operations were studied over 18 theatre sessions. The median number of scheduled cataract operations was 7 (range: 5-14). The average duration of an operation was 10.3 min±(SD 4.11 min). The average time to complete one case including patient turnaround was 19.97 min (SD 8.77 min). The proportion of the surgeons' time occupied on total duties or operating ranged from 65.2% to 76.1% and from 42.4% to 56.7%, respectively. The correlations of the surgical time to patient time in theatre was R2=0.95. A multiple linear regression model found a significant association (F(3,111)=32.86, P<0.001) with R2=0.47 between the duration of one operation and the number of allied healthcare professionals (AHPs), the number of AHP key tasks 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. Supporting the surgeon with sufficient AHPs and tasks performed by AHPs could improve surgical efficiency up to approximately double productivity over conventional theatre models.

Original languageEnglish
Article number2017-310452
Pages (from-to)1259-1267
Number of pages9
JournalBritish Journal of Ophthalmology
Volume109
Issue number9
Early online date24 Nov 2017
DOIs
Publication statusPublished - 1 Sep 2018
Externally publishedYes

Fingerprint

Time and Motion Studies
National Health Programs
Cataract
Delivery of Health Care
Efficiency
Linear Models
Private Hospitals
Operative Time
Regression Analysis

Keywords

  • treatment surgery

Cite this

Roberts, Harry W. ; Myerscough, James ; Borsci, Simone ; Ni, Melody ; O'Brart, David P.S. / Time and motion studies of National Health Service cataract theatre lists to determine strategies to improve efficiency. In: British Journal of Ophthalmology. 2018 ; Vol. 109, No. 9. pp. 1259-1267.
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Time and motion studies of National Health Service cataract theatre lists to determine strategies to improve efficiency. / Roberts, Harry W. (Corresponding Author); Myerscough, James; Borsci, Simone ; Ni, Melody; O'Brart, David P.S.

In: British Journal of Ophthalmology, Vol. 109, No. 9, 2017-310452, 01.09.2018, p. 1259-1267.

Research output: Contribution to journalArticleAcademicpeer-review

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