Optimising cost effectiveness of health care is the modern challenge for the NHS. Trusts in England estimate a £2.3 billion deficit by the end of 2016. It is therefore essential that every effort is made to make each service as efficient and as cost-effective as possible, without compromising patient care. Operating theatres are one of the most expensive areas in a hospital to run, with an average cost of approximately £1200 per hour. They also represent one of the most profitable areas of healthcare delivery for NHS trusts, if delivered efficiently. Streamlining could lead to significant savings. For example, the NHS Institute for Innovation and
Improvement calculate that the average trust has an opportunity to save £7 million a year in efficiency savings by running a ‘productive theatre’. 2 According to the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man, 85,972 primary total hip replacements and 94,814 primary total knee replacements were performed in 2014.
The ageing population is expected to create increasing demand for such orthopaedic services. Failure to improve output in the face of increasing demand will increase waiting lists, causing prolonged discomfort, decreased quality of life and additional morbidity. Improved efficiency with greater theatre output will help to reduce the waiting times for routine surgery. Hamilton and colleagues concluded that meeting waiting time targets is one of three factors which improve patient satisfaction with joint arthroplasty, and so it is imperative that every attempt is made to ensure waiting times are kept to a minimum. The aim of this project is to reduce the time between cases in an elective orthopaedic theatre setting.
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