What is acute surgery?
There are two types of surgery, elective (planned) and acute (urgent or unexpected). Acute surgery is for situations such as a bone fracture or appendicitis and accounts for over half of all operations completed in our theatres at North Shore Hospital. It has a highly variable workload with estimated operating workload hours on a given day ranging from 15 to 45 hours.
What have we done?
In the last year we have increased our capacity to do more acute surgery by making changes like adding more operating sessions for both general surgery (an additional 2 per week) and orthopaedic surgery (an additional 4 per week).
We have also employed a surgeon whose role is to manage the acute orthopaedic patient flow during the week. Despite these changes, difficulties still remain in how:
- we make sure acute surgeries happen in a safe and timely manner
- we measure the acute theatre’s performance
- future capacity will be planned for as the demand continues to increase
We have formed an Acute Theatre Group (ATG) consisting of surgeons from all the acute surgery specialties, anaesthetists and theatre nurses. The group has identified a number of areas for improvement that will help us manage the growing workload in our theatres.
- identifying demand for acute surgery by surgery type
- establishing an agreed prioritisation process to ensure that we operate on the most appropriate patient within the most appropriate timeframe
- setting up performance measures related to clinical safety
- developing and agreeing on a process for opening more theatres, calling in extra staff when there is a need to complete more surgery than is currently possible
- developing ways of displaying this information in real-time that staff anywhere in the hospital can access
These areas of improvement require a number of smaller projects to achieve success. View more about projects featured in this quality account:
Work has also commenced in the following areas:
- Procedure Time Analysis & Grouping
- Electronic Communication Between Theatre & Ward
- Theatre Turnaround Time
- Theatre Workload Planning
- Ward Readiness Planning
- Acute Appendicitis Pathway
- Acute Laparoscopic Cholecystectomy Pathway
- Preoperative Checklist Redesign
- Orderly Workload Mapping
- Escalation Process