Journal of perioperative practice
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The NHS Management Executive recommends that hospitals should aim to use 90% of planned theatre time and that theatre utilisation should be used as a key performance indicator. This study aims to investigate the impact of late-starts and overruns on theatre utilisation rates. Data were retrieved from a prospectively updated theatre database for all elective plastic surgical main theatre operating sessions carried out over a one year period. ⋯ In contrast, overrunning lists demonstrated much higher utilisation rates than those that finished before the end of the session (96.7% versus 76.6% respectively, p < 0.001). The study shows that late-starts and overruns represent obvious sources of theatre inefficiency yet their impact on utilisation is misleading: overruns exaggerate theatre usage and late-starts have little impact upon it. We conclude that the use of utilisation as a marker of theatre performance requires caution.
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Over 40 million surgical procedures are performed per annum in the USA and Europe, including several million patients who are considered to be high risk (Bennett-Guerrero et al 2003). Overall, the risk of death or major complications after surgery in the general surgical patient population is low, with a post-operative mortality rate of less than1% during the same hospital admission (Niskanen et al 2001).