• Bishoy A B Soliman, Raymond Stanton, Steven Sowter, Warren Matthew Rozen, and Shekib Shahbaz.
• Urology Department, Westmead Hospital, Sydney, New South Wales, Australia. bish.soliman@gmail.com
• ANZ J Surg. 2013 Jul 1;83(7-8):545-8.

BackgroundOperating theatre inefficiency and changeover delays are not only a significant source of wasted resources, but also a familiar source of frustration to patients and health-care providers. This study aimed to prove that the surgical registrar through active involvement in patient changeover can significantly improve operating room efficiency and minimize delays.MethodsA two-phase prospective cohort study was undertaken, conducted over the course of 4 weeks at a single institution. The only inclusion criteria comprised patients to undertake endoscopic urological day surgery cases and require general anaesthesia. There were no exclusions. In the first phase (observational, with no intervention), changeover times between cases were documented. The second phase followed a structured intervention, involving the surgical registrar being actively involved in the patient's operative journey. Outcome measures were qualitative measures of operative efficiency. Statistical analysis was undertaken.ResultsThere were 42 patients included in this study, with 21 patients in each of its arms. A 48% (P-value < 0.01) reduction in overall case changeover times was demonstrated with the utilization of a structured intervention from 27.7 min (95% confidence interval (CI) 22.8-32.7%) to 15.7 min (95% CI 13.2-18.2%). The intervention results were statistically significant (P-value < 0.05) for all markers of efficiency except for the waiting time in the anaesthetic holding bay (P-value 0.13).ConclusionThe surgical registrar can improve operating room efficiency by using a structured intervention, ultimately reducing patient changeover times.© 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

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