Operation Theatre Utilization & Efficiency: A cross sectional prospective study from a tertiary Hospital in Ethiopia

Abstract

Abstract Background: Operation Theatre is one of the most expensive facility within the hospital, which demands more than one third of the total hospital budget. Under-utilization of operating theatre has been a significant problem both for surgeons and hospital administrators, and causes significant negative impact for patient’s satisfaction. In developing countries, where resources are limited, inefficient utilization of operating theatre is a significant problem, where only few studies have been reported. Objective: The aim of this study is to assess the utilization and efficiency of operating theatre in surgery and gynecology departments at St. Paul’s Hospital Millennium Medical College from June to September 2022. Methods: A cross-sectional study was carried out by taking all complete and documented records of patients who have undergone elective surgical procedures in specific departments/units within the study period at St. Paul’s Hospital Millennium Medical College. A checklist prepared in English language used to collect data. The collected data entered into a computer using Statistical Package for Social Sciences version 25.0 for windows. Means, standard deviations and percentages will be calculated. Moreover, relationship measures between variables was assessed using Chi-square. In the meantime, statistical significance was accepted at P-value < 0.05. The results are presented by the use of charts, tables, and texts Results: A total of 822 elective procedures were scheduled, amongst 747 (90.9%) cases were operated averaging around 2.5 cases per table per day. Among 144,480 working minutes available for elective surgery, 128,766 minutes was used, averaging 427.7±139 minutes per operating room in a given day. There were 75 cancellations, making cancellation rate to be 9.12%. The commonest reason for cancellation being lack of OR time (46.7%), medical reasons which make them unfit for the surgery (28%) and lack of operating materials & facilities (10%).The mean Start time, turnover and finishing time was 8: 02A.M ± 0:24, 0:22±26 minutes & 2:59P.M ± 2:17 respectively. Delayed turnover time was seen in 21.9%, with 43 ± 26 minutes. The total utilization rate of was calculated to be 89.11%, ranging from 70.93% to 102.5%. Overall efficiency rate was 75.6%, ranging from 60.3% to 84.4%. Operating rooms were underutilized in 42.7% while overutilization was found in 14.6%. Conclusion and Recommendation: There was high rate of cancellation rates and higher proportion of overrunning times in the study. There was better utilization rates and slightly lower efficiency rates from the acceptable standards, which were having statistically significant relations with early finishes, overrunning times and number of surgeries performed in a day. Improvements in proper utilization of available OR times to avoid early finishes, minimizing the overrunning hours is recommended to increase the efficiency rate of our OR performance. Keywords: Operating room, Operating Theatre, Utilization, Efficiency Rate, turnover time, Operating room Delays, Cancellation Rate