Surgical Registrars Advance Operating Theatre Efficiency

A new study claims that by using a structured intervention, the surgical registrar can improve operating room efficiency and minimize delays.

Researchers at Westmead Hospital (Sydney, Australia) conducted a two-phase prospective cohort study over the course of four weeks. The only inclusion criteria were patients that needed endoscopic urological day surgery and required general anesthesia (GA); there were no exclusions. In the first phase (observational, with no intervention), changeover times between cases were documented. The second phase followed a structured intervention that demanded that the surgical registrar be actively involved in the patient's operative journey. The main outcome measures were qualitative measures of operative efficiency.

In all, there were 42 patients included in the study, with 21 patients in each of its arms. The researchers found a 48% reduction in overall case changeover times with the utilization of a structured intervention, from 27.7 minutes to 15.7 minutes. The intervention results were statistically significant for all markers of efficiency except for the waiting time in the anesthetic holding bay. The study was published ahead of print on November 27, 2012, in the Australian and New Zealand Journal of Surgery.

“Operating theatre inefficiency and changeover delays are not only a significant source of wasted resources, but also a familiar source of frustration to patients and healthcare providers,” concluded lead author Bishoy Soliman, MD, and colleagues of the department of urology. “The surgical registrar can improve operating room efficiency by using a structured intervention, ultimately reducing patient changeover times.”

Registrars are qualified medical doctors who at the outset of their higher medical training are beginning to specialize in a particular medical specialty, and by the end of it will be looking at obtaining a consultant post in that area. Typically, a registrar will follow a program of structured vocational and academic higher medical training, perhaps involving an additional educational qualification.

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