Open Access Research Article
Anesthesia & Clinical
Research
Oluwadiya et al., J Anesth Clin Res 2012, 3:5
http://dx.doi.org/10.4172/2155-6148.1000210
Volume 3 • Issue 5 • 1000210
J Anesth Clin Res
ISSN: 2155-6148 JACR an open access journal
Keywords: eatre; Utilization; Developing country
Introduction
Previous studies from Nigeria have shown a high rate of cancella-
tion of scheduled surgeries on the days of surgeries [1-3]. One of the
causes attributed to these delays was inefficient utilization of theatre
time, mainly due to long turnaround times; causing lists overrun and
postponement of cases lower on the operating lists [3]. Such cancella-
tions inevitably lead to future inefficiency, because they swell the op-
eration waiting list, increases the risk of further cancellations, which
may cause patient’s dissatisfaction and compromise patient’s safety [4].
Economic considerations also suggest that it is desirable to keep operat-
ing rooms fully used. us, it is imperative that areas of time wastage
in the theatre time flow be recognized and their causes identified. is
will assist theatre managers take necessary steps to correct the problem.
is study was an investigation of theatre time utilization at the
LAUTECH Teaching Hospital (LTH), Osogbo, Osun State in Nigeria.
It is hoped that insights gained from the study will be useful not only to
the LTH, but to other hospitals in similar resource poor settings.
Method
Setting
is prospective observational study was conducted at the LTH, a
500-bed teaching hospital and a tertiary referral centre in southwest Ni-
geria. e main theatre consists of three suites serving all non-obstetric,
non-endoscopic elective and emergency cases in the hospital, a pre-an-
aesthetic waiting area and a recovery room. All elective lists are sched-
uled to run between 8.00 am and 4.00 pm daily on weekdays (Monday-
Friday). Nights, weekends and holidays are reserved for emergencies.
Surgical and gynaecological departments are organized into units with
each unit having an allocated time (AT) of 8-hours per week to run a
list for its elective cases.
Staffing
ere were 7 Porters/Nursing assistants, 13 eatre Nurses, 3 An-
aesthetic assistants, 7 Anaesthetic nurses, 3 Anaesthesia resident doc-
tors, 3 fulltime and one locum Anaesthesiologists and 18 Surgeons in
the theatre. ese staffs also run the obstetric theatre which is located
in another building. e head nurse in the theatre is responsible for the
administration of the theatre while the head of anaesthesia. e general
theatre activities are overseen by a eatre Users Committee (TUC),
with the head of surgery as the chairman. Other members are from
Nursing, Anaesthesia, Administration and Technical departments.
eatre procedure
Each unit is expected to submit its operation list to the theatre and
anaesthesia department before 15:00 hours on the day before its as-
signed operation day. In the evening before the surgery, anaesthetists
and theatre nurses are expected to do a pre-operative ward round on
patients who had been scheduled for surgery. ey are expected to re-
assure these patients, assess their fitness for surgery, and also check to
see that these patients have paid the necessary hospital fees.
Patient is not sent for until surgeon arrives in the theatre. Porters
*Corresponding author: Dr. Oluwadiya KS, Department of Surgery, LAUTECH
Teaching Hospital, Osogbo, Osun State, Nigeria. Tel: +2348035029563; E-mail:
oluwadiya@gmail.com
Received May 17, 2011; Accepted May 20, 2012; Published May 23, 2012
Citation: Oluwadiya KS, Osinaike BB, Eziyi AK, Oyebamiji EO, Kolawole IK
(2012) A Theatre Time Utilization Survey in a University Teaching Hospital from
a Developing Country. J Anesth Clin Res 3:210. doi:10.4172/2155-6148.1000210
Copyright: © 2012 Oluwadiya KS, et al. This is an open-access article distributed
under the terms of the Creative Commons Attribution License, which permits un-
restricted use, distribution, and reproduction in any medium, provided the original
author and source are credited.
A Theatre Time Utilization Survey in a University Teaching Hospital from
a Developing Country
Kehinde S. Oluwadiya
1
*, Babatunde B. Osinaike
2
, Amogu K. Eziyi
1
, Emmanuel O. Oyebamiji
3
and Israel K. Kolawole
4
1
Department of Surgery, LAUTECH Teaching Hospital, Osogbo, Osun State, Nigeria
2
Department of Anaesthesia, University College Hospital, Ibadan, Oyo State Nigeria
3
Department of Anaesthesia, LAUTECH Teaching Hospital, Osogbo, Osun State, Nigeria
4
Department of Anaesthesia, University of Ilorin Teaching Hospital, Kwara State, Nigeria
Abstract
Background: Previous studies from the West African sub-region have shown a high cancellation rate of
scheduled elective surgeries, but no studies from the same region had looked at the efficiency of theatre time
utilisation. Our objective was to identify areas of, and causes of theatre time delay, and suggests solutions based on
the identified deficiencies.
Methods: Data on all patients undergoing elective surgeries were prospectively collected using a proforma to
determine the duration of each step of patients’ surgery starting from when patients were sent for, and ending with
when patients left the operating room. The causes for delays were determined.
Results: 279 elective cases were analysed. None of the first-on-the-list cases started as scheduled. The most
common cause of delay was delayed transfer of patients from the wards to the theatre, and this occurred in 104
(33.4%) cases. The time spent in transferring patients from the ward ranged between 18% and 54 % of the total time
spent from ward to the end of surgery. Most delays were due to poor coordination of patients’ movement between
the wards and the theatre as well as long distances between the wards and the theatre.
Conclusion: Available theatre time is poorly utilized. To improve the overall efficiency of the theatre, qualitative
improvement strategies should be instituted.