• D Ricketts, J Hartley, M Patterson, W Harries, and D Hitchin.
• Department of Orthopaedics, Central Middlesex Hospital, London.
• Ann R Coll Surg Engl. 1994 May 1;76(3):200-4.

AbstractThe efficient use of operating lists is important to clear waiting lists and because they are expensive to run (at 1988 prices, 151 pounds per hour). Of general surgical theatre session time, 49% is used for performing operations, but no survey of orthopaedic theatre sessions has been published. In light of this we surveyed 151 elective orthopaedic lists at three hospitals. Our aims were to determine the use of operating rooms and the reasons for inefficient use of time. We found 60% of elective list time was used for operating and 21% for turnover. No useful activity occurred during the remaining 19% of theatre time. An average start delay of 26.5 min and average early finish of 14.5 min contributed to this. Only 9/151 (6%) of lists started within 5 min of the scheduled time. Of unnecessary delays contributing to this, 63% involved anaesthetic staff and 24% theatre staff. Surgeons were implicated in 10% of start delays. There were less start delays if senior anaesthetic staff were present. During lists, turnover times were quicker if a consultant surgeon was present (P = 0.0022). We conclude that more efficient use of elective orthopaedic theatre sessions is possible and could be achieved if more detailed preparation was undertaken by the anaesthetic, theatre and surgical staff concerned. If a consultant surgeon is present the list is likely to proceed with fewer delays.

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