Report 25

Operating Theatre Efficiency

Audit Focus and Scope

The audit examined whether public hospitals are managing operating theatres efficiently and focused on three lines of inquiry:

  • Do hospitals use operating theatre data to monitor and measure operating theatre efficiency?
  • Do hospitals have surgery scheduling systems and practices that optimise the use of operating theatres?
  • Are hospitals managing operating theatres to ensure that the right staff are available at the right time?

The audit sample included Sir Charles Gairdner Hospital (SCGH), Osborne Park Hospital (OPH) and Swan District Hospital (SDH) within the North Metropolitan Health Service, and Bunbury Hospital (BH) and Albany Hospital (AH) within the WA Country Health Service.

We analysed Health’s operating theatre data for elective cases booked into elective sessions over a six year period. We assessed the hospitals’ performance using six measures of operating theatre efficiency drawn from other Australian jurisdictions and internationally (including New South Wales, Victoria and Ontario):

  • theatre utilisation (which is different to Health’s sole indicator of Theatre Activity)
  • on time starts for the first case
  • sessions that finish early
  • sessions that finish late
  • day of surgery cancellations
  • average turnaround time between cases.

The appendices provide more information about the measures and hospital performance against them.

We met with Health staff who are responsible for managing operating theatres and monitoring performance. We observed operating theatres in action during five sessions to better understand the surgical environment.

We consulted with key medical and surgical stakeholders and engaged a subject expert to provide specialist analysis and advice. We did not assess clinical processes or outcomes.

This was a broad scope performance audit, conducted under section 18 of the Auditor General Act 2006 and in accordance with Australian Auditing and Assurance Standards. Performance audits primarily focus on the effective management and operation of agency programs and activities.

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