PMID- 29175969
OWN - NLM
STAT- MEDLINE
DCOM- 20190328
LR  - 20190328
IS  - 1468-2079 (Electronic)
IS  - 0007-1161 (Linking)
VI  - 102
IP  - 9
DP  - 2018 Sep
TI  - Time and motion studies of National Health Service cataract theatre lists to
      determine strategies to improve efficiency.
PG  - 1259-1267
LID - 10.1136/bjophthalmol-2017-310452 [doi]
AB  - 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 R(2)=0.95. A multiple linear regression model found a significant
      association (F(3,111)=32.86, P<0.001) with R(2)=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.
CI  - (c) Article author(s) (or their employer(s) unless otherwise stated in the text
      of the article) 2018. All rights reserved. No commercial use is permitted unless 
      otherwise expressly granted.
FAU - Roberts, Harry W
AU  - Roberts HW
AUID- ORCID: 0000-0002-3590-0856
AD  - Department of Ophthalmology, Guy's and St. Thomas' NHS Foundation Trust, London, 
      UK.
AD  - Department of Diabetes & Nutritional Sciences, King's College London, London, UK.
FAU - Myerscough, James
AU  - Myerscough J
AD  - Cambridge University Hospital NHS Foundation Trust, Cambridge, UK.
FAU - Borsci, Simone
AU  - Borsci S
AD  - Division of Surgery, Department of Surgery and Cancer, Imperial College London,
      St Mary's Hospital, London, UK.
FAU - Ni, Melody
AU  - Ni M
AD  - Division of Surgery, Department of Surgery and Cancer, Imperial College London,
      St Mary's Hospital, London, UK.
FAU - O'Brart, David P S
AU  - O'Brart DPS
AD  - Department of Ophthalmology, Guy's and St. Thomas' NHS Foundation Trust, London, 
      UK.
AD  - Department of Diabetes & Nutritional Sciences, King's College London, London, UK.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20171124
PL  - England
TA  - Br J Ophthalmol
JT  - The British journal of ophthalmology
JID - 0421041
SB  - IM
MH  - Cataract Extraction/*standards
MH  - Humans
MH  - National Health Programs/*standards
MH  - Operating Rooms/*standards
MH  - Operative Time
MH  - Prospective Studies
MH  - *Time and Motion Studies
MH  - United Kingdom
OTO - NOTNLM
OT  - *treatment surgery
COIS- Competing interests: None declared.
EDAT- 2017/11/28 06:00
MHDA- 2019/03/29 06:00
CRDT- 2017/11/28 06:00
PHST- 2017/03/23 00:00 [received]
PHST- 2017/09/24 00:00 [revised]
PHST- 2017/11/04 00:00 [accepted]
PHST- 2017/11/28 06:00 [pubmed]
PHST- 2019/03/29 06:00 [medline]
PHST- 2017/11/28 06:00 [entrez]
AID - bjophthalmol-2017-310452 [pii]
AID - 10.1136/bjophthalmol-2017-310452 [doi]
PST - ppublish
SO  - Br J Ophthalmol. 2018 Sep;102(9):1259-1267. doi:
      10.1136/bjophthalmol-2017-310452. Epub 2017 Nov 24.