The Effect of the COVID-۱۹ Pandemic on Theatre Efficiency, Lessons to be Learned for Subsequent Waves

Background: This study aims to demonstrate the impact of the COVID-۱۹ pandemic on providing trauma services at our district general hospital. We aim to identify the impact on specific areas of theatre delay to help optimize theatre efficiency and generate better protocols and improve patient flow for future pandemic waves.Methods: Patients who underwent orthopaedic trauma surgery at our hospital between July-August ۲۰۱۹ (preCOVID-۱۹) and ۲۰۲۰ (first UK wave of COVID-۱۹) were identified retrospectively and grouped by year of operation. Type of operation was recorded, including time for sending, anaesthetic induction, surgical preparation, operating time, and time for transfer to recovery. The two groups were compared for analysis.Results: Case numbers were similar in both ۲۰۱۹ and ۲۰۲۰ (۲۱۵vs.۲۱۳ operations), with a similar proportion being hip fractures (۳۹.۱% and ۳۶.۶%), respectively. Median sending time (۴۰vs.۲۳ minutes, P <۰.۰۰۰۰۱) and induction time (۱۳vs.۸ minutes, P<۰.۰۰۰۰۱) were increased in ۲۰۲۰, a ۷۴% and ۶۳% increase compared to ۲۰۱۹, respectively. Median surgical preparation time (۳۵vs.۳۷ minutes, P=۰.۰۶) and operating time (۵۶vs.۵۰ minutes, P=۰.۱۶) were not statistically significant. Transfer time in ۲۰۲۰ (۱۶vs.۱۳ minutes, P<۰.۰۰۰۰۱) was significantly increased. Overall case time increased in ۲۰۲۰ (۲:۴۰vs.۲:۱۱, P<۰.۰۰۰۰۱) by ۲۹ minutes.Conclusion: COVID-۱۹ had a significant impact on theatre efficiency in our hospital, causing multiple points of delay. As hospitals across the UK restart crucial elective services, focus should be given to maximizing theatre efficiency by providing rapid access COVID-۱۹ testing for patients undergoing emergency surgery. We have proposed and implemented several steps for better theatre utilization. Level of evidence: IIIBackground: This study aims to demonstrate the impact of the COVID-۱۹ pandemic on providing trauma services at our district general hospital. We aim to identify the impact on specific areas of theatre delay to help optimize theatre efficiency and generate better protocols and improve patient flow for future pandemic waves.Methods: Patients who underwent orthopaedic trauma surgery at our hospital between July-August ۲۰۱۹ (preCOVID-۱۹) and ۲۰۲۰ (first UK wave of COVID-۱۹) were identified retrospectively and grouped by year of operation. Type of operation was recorded, including time for sending, anaesthetic induction, surgical preparation, operating time, and time for transfer to recovery. The two groups were compared for analysis.Results: Case numbers were similar in both ۲۰۱۹ and ۲۰۲۰ (۲۱۵vs.۲۱۳ operations), with a similar proportion being hip fractures (۳۹.۱% and ۳۶.۶%), respectively. Median sending time (۴۰vs.۲۳ minutes, P <۰.۰۰۰۰۱) and induction time (۱۳vs.۸ minutes, P<۰.۰۰۰۰۱) were increased in ۲۰۲۰, a ۷۴% and ۶۳% increase compared to ۲۰۱۹, respectively. Median surgical preparation time (۳۵vs.۳۷ minutes, P=۰.۰۶) and operating time (۵۶vs.۵۰ minutes, P=۰.۱۶) were not statistically significant. Transfer time in ۲۰۲۰ (۱۶vs.۱۳ minutes, P<۰.۰۰۰۰۱) was significantly increased. Overall case time increased in ۲۰۲۰ (۲:۴۰vs.۲:۱۱, P<۰.۰۰۰۰۱) by ۲۹ minutes.Conclusion: COVID-۱۹ had a significant impact on theatre efficiency in our hospital, causing multiple points of delay. As hospitals across the UK restart crucial elective services, focus should be given to maximizing theatre efficiency by providing rapid access COVID-۱۹ testing for patients undergoing emergency surgery. We have proposed and implemented several steps for better theatre utilization. Level of evidence: III

کلیدواژه ها:

COVID-۱۹ ، Orthopaedics ، Theatre efficiency ، Theatre utilization ، Trauma