SP4.06 Scheduled Emergency Theatre (SET) Lists – Improving emergency surgery theatre capacity and utilisation at a tertiary level hospital

Introduction Emergency operations are time critical. Lack of emergency theatre capacity results in delays longer than the appropriate level of urgency or cases unnecessarily being done out-of-hours. This presents challenges for staff, suffering for patients and operational challenges. Methods Three audits were done over 3 consecutive years with implementation of changes in theatre capacity and usage between each cycle. The audits assessed data for 1000 consecutive cases booked on the emergency CEPOD list for all surgical specialties. Data were analysed to quantify and compare the impact of changes implemented and presented at board meetings, business plans proposed and implemented. Results Audit 1 – Demonstrated 23% of all cases booked on the CEPOD list were delayed due to multiple causes. Improvement in accuracy in booking of case urgency to allow appropriate prioritisation was implemented Audit 2 – No significant change was seen in delays to cases (22%). High burden of cases on the CEPOD list was identified as cause for delay. A business plan for Scheduled Emergency Theatre (SET) lists was approved to increased emergency general surgery theatre capacity Audit 3 – An improvement was seen, with 17% of emergency cases suffering delays. Extra theatre capacity allowed 200 more cases to be carried out separate to the CEPOD list. Conclusions Progressive improvements in theatre utilisation, reducing burden on CEPOD lists, preventing addition to already overwhelmed elective waiting lists are achievable. This requires balancing of goals and objectives of clinicians and management to deliver changes.