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News and updates from today's Effective Operating Theatres Summit

Following the chair's introductions and welcome, Mona Guckian Fisher Immediate Past President The Association for Perioperative Practice Clinical Director Guckian Fisher Limited, opens the conference by discussing 'Effective Operating Theatres' covering:

• advancing standards and reducing the variability of patient outcomes
• improving efficiency and productivity in operating theatres
• looking ahead to the operating theatre of the future

Notes from Mona's presentaton; Every 36 hours NHS treats over 1 million people.
40% more operations in 2015/16 compared to 2005/6 & set to increase further.
Good briefings & communication with all members of staff involved is necessary. 
Important to maintain good relationships with key colleagues who can impact/influence on the day in theatre
Process of booking cases/patients into theatre is important & have a relationship with booking team so we know details/profiles.
Make sure you have everything you need beforehand. It’s not easy & not always possible but it is practical
Commitment to the process from all parties involved is key.
Important to have the backing & support of the executive/management to team when implementing process. Key when changes may be unpopular with individuals.
High level policy & procedure ensures consistency in decision making. The framework has to be followed. Eliminates/reduces confusion.
Leadership - needs to have knowledge & experience of clinical environment; dealing with daily challenges & when unforeseen circumstances arise
Staffing is major challenge in the UK & internationally – need to make sure we are providing a competent & skilled workforce
Need  to know timings, patient profiles, also patient movement etc so that we can provide correct staffing
"The Standard we walk past is the Standard we accept” Don’t be beaten down – don’t accept lower standards

Mona's presentation abstract:  Reducing variability for patient outcomes is a major focus for perioperative practitioners and the organisations they represent. Applying a focused and standardised model of practice is paramount to providing quality care that can be measured, assuring patients that nationally recognised standards of clinical and operational practice are in use.  This discussion will consider a basic model of perioperative care which can provide the foundation on which theatre efficiency and productivity can be managed.  With this groundwork complete the perioperative practitioner is empowered to provide the   appropriate and up to date standards of clinical care, managing the operational service providing safe and consistent perioperative care today and into the future.

Conference chair,  Mr Hugh Rogers continues by asking 'What have we learned from the Productive Operating Theatre Programme?' discussing:

• have we achieved a step change in operating theatre performance?
• improving efficiency and productivity in operating theatres
• improving reliability and outcomes
• system issues and enablers for change
• moving forward: critical success factors

Notes form Mr Roger's presentation; Huge amount of resource for any hospital is committed to operating theatre so a no brainer that efficiency should be worked on
Modular improvement programme – systematic approach
Started with foundations – started with 3 test sites – what Programme Leader& Executive Leaders deal with
The whole thing was done over a period of time. Things will not change of overnight
Visioning workshop – the shared vision must be agreed as a team
Barriers/Frustrations- start/finish; flow/scheduling; team working/communication
Role of Exec Leader – get them involved; invite them into theatre so they become familiar with how everything works & what is needed
Run charts are a very good way of showing data & are familiar to most involved making it easier for them to understand
Who is the leader in theatre? Everyone is a leader – all have leadership roles
If they don’t communicate or work together they will not be efficient
Do we concentrate on human factors enough in theatres?
Enhanced Recovery pathway was missed as was just becoming relevant at time programme was developed
Role of IT also missed as this was/is still developing & develops at different rates in different trusts

Full PowerPoint Presentation

Mr Hugh Roger's Biography: I am a consultant urologist, and for most of my career I have been involved in quality improvement at local and national level in the NHS. I worked on lean implementation programs - notably the Productive Series - for the NHS Institute for Innovation & Improvement until it was consumed by the ‘bonfire of the Quangos’ in 2011. I had a leading role in The Productive Operating Theatre program (‘TPOT’) and rolled out a nationwide series of training workshops in human factors applied to the operating theatre.

My current work as Associate Medical Director is to help steer innovation and transformation within a newly integrated organization.  We are now working on a substantial IT implementation which will utterly change the way clinicians work.  In addition my time as CQC special advisor has given me privileged insight into the way different trusts are improving their operating theatre performance.

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