Theatre efficiency
efforts could potentially save very valuable resources.6
Preventive measures can be
delivered through the implementation of quality improvement programmes (QIPs), which allow Trusts to both test the implementation of best- practice recommendations within their specific standards of care, and compare them against other processes and procedures. A case study on how to reduce the backlog
through improved efficiencies can be found at the Northumbria Healthcare NHS Foundation Trust. The Trust examined the patients on the waiting list for treatment, prioritising patients by clinical need, as well as using experts on population health and inequalities to ensure resources were directed in the right places. These actions were part of a project that also sought to improve communication between primary and secondary care through the through the enhancing of mutual advising and guidance sharing. The results were very successful: up to the
end of April 2021, Northumbria Healthcare had just 131 patients waiting more than 52 weeks, representing just 0.56% of the total national waiting list. Moreover, the Trust had no patients waiting more than two years for elective surgery, which firmly put the Trust among the best performing in England.7
The role of new technologies Innovation in the operating theatre also has a role to play in the mission to tackle the backlog. With this aim in mind, participants from our roundtable agreed that the deployment of the latest technologies and devices should be a core part of any plans designed to improve efficiencies in the health system. Embedding innovation does not need to be a complex task, as innovation can come in relatively simple form. An example of this can be found in Mölnlycke’s procedure trays. Crucially, these trays allow clinicians to customise the sterile packs by including components surgical teams need for specific interventions. This has shown to reduce preparation time for surgeries by up to 40%, thus almost halving the time length of this step of the patient pathway.8
Another of these simple to embed devices are patient warming blankets. Warming blankets are one of the most reliable methods to reduce the risk of hypothermia in the operating theatre. The incidence of unintended hypothermia ranges from 50% to 90% and research has shown that perioperative hypothermia poses serious risks to patients undergoing surgery, including prolonged length of stay in hospital, coagulation disorders, cardiac complications, delayed wound healing and increased risk of infection. Overall, there is overwhelming evidence that patients that are warmed recover better from both surgery and anaesthetic.9 Warming blankets thus provides a convenient patient-warming solution that can be utilised by perioperative teams before, during and after surgery to counteract the risk of patient hypothermia. By reducing the risk of surgical infections, they can also potentially reduce the time and costings associated to each patient in very significant ways. Any discussion about innovation must also
include a mention of value-based procurement (VBP) solutions. VBP accounts for the value of
The incidence of unintended hypothermia ranges from 50% to 90% and research has shown that perioperative hypothermia poses serious risks to patients undergoing surgery, including prolonged length of stay in hospital, coagulation disorders, cardiac complications, delayed wound healing and increased risk of infection.
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products beyond cost per unit and considers how the product reduces risk for healthcare professionals across the pathway, which has considerable efficiency benefits in the medium and long term.
By ensuring that the product provides
better protection to patients and healthcare professionals or saves time in the operating theatre by reducing theatre set-up time, VBP invests in all areas of organisation and consequently delivers time and cost savings for Trusts. As I have stated before, we have to remember that the more efficient an operative theatre is, the more productive and safer it will become. However, not all innovative solutions have
to be physical. Relatively simple, innovative initiatives have proven to play a key role in helping to improve care and deliver efficiencies. Published in June 2022, our company worked collaboratively with leading clinical experts to deliver a QIP on SSIs. The document outlines the importance of statistical process control as the main tool to collect, process and audit data about past and current SSI incidents. This enables Trusts to identify the root of the problem and design standardised protocols to address it. Quality improvement is an ongoing cycle of measurement and re-measurement that has the potential to embed strategies for improvement into everyday practice.
New ways of working When reflecting how to reduce the backlog in elective care, one of the most critical components to consider is the workforce. Without a workforce that feels safe and
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