Appendix 2: Operating Theatre Performance Measures

Health does not have a set of performance measures to monitor operating theatre efficiency across the state. We have therefore assessed operating theatre efficiency based on six established measures and research from other jurisdictions.

Theatre Utilisation

Theatre Utilisation is a measure of how much time operating theatres are occupied by patients of the total time the theatres are allocated for use. NSW’s target is 80 per cent. Theatre Utilisation has only been calculated for elective sessions and used theatre time excludes turnaround time. Theatre utilisation is shown in comparison with Health’s Theatre Activity measure (Appendix 5).

First case start on time

First case start on time reports the proportion of sessions where the first case of the session starts on or before the scheduled session start time. WA does not have a target, but the Theatre Management System (TMS) in use at hospitals allows for sessions to start within 10 minutes of the scheduled session start time. NSW has a target of 95 per cent of sessions to start on or before the scheduled start time (no grace given).

Underruns

Underruns is a measure of the number of sessions that finished before the scheduled finish time. There is no recognised target or best practice available in the literature, other than the need for this measure to be appropriate, based on the case mix of the hospital. Our analysis identified that the average elective case time across all the sample hospitals was 70 minutes, so it was determined that underruns would be reported as sessions that finish more than one hour before the scheduled finish time.

Overruns

Overruns is a measure of the number of sessions that finished after the scheduled finish time. There is no recognised target or best practice available in the literature, other than the need for this measure to be appropriate based on the case mix of the hospital. Our analysis identified that the average case time across all the sample hospitals was 70 minutes, so it was determined that overruns would be reported as sessions that finish more than one hour after the scheduled finish time.

Day of Surgery Cancellations

Day of surgery (DOS) cancellations is the proportion of elective cases that are cancelled on the day of surgery. WA does not have a target for DOS cancellations. The NSW target for DOS cancellations is less than two per cent. However, research from the United States indicates that for tertiary hospitals, it may be more appropriate to set a higher target to allow for an increased number of cancellations on the day of surgery due to the nature of the patients (tertiary hospitals typically treat higher risk patients). Based on these factors we believe an appropriate target for DOS cancellations for tertiary hospitals is less than five per cent.

Turnaround Times

Turnaround time is the average number of minutes between one patient exiting the operating theatre and the next patient in the same session entering the operating theatre. WA does not have a target for turnaround time, and there is no common target in other jurisdictions.