WA Health welcomes the Operating Theatre Efficiency report and accepts the recommendations of the OAG.

WA Health has provided comprehensive report feedback to the OAG, detailing additional key theatre reform strategies implemented during the audit period, those currently underway, and future surgical improvement activities planned at site and system level. The report highlights the complexity of both theatre measurement for comparable efficiency performance and the complexity of scheduling, requiring active management of both emergency and elective surgery theatre demands.

Theatre efficiency remains a key priority for WA Health for both the delivery of safe, high quality, patient-focused care and to provide value for money and meet public expectations. To achieve this, WA Health’s reform approach involves examination of processes in all other related areas that impact on theatre performance, including referral, booking, patient preparation, scheduling, admission and discharge.

With the implementation of the National Elective Surgery Targets (NEST) in 2012, WA Health established state-wide governance and support structures to drive improvements in patient access to elective surgery. This included strengthened leadership by hospital executive and expert clinicians through establishment of an elective demand steering group to drive key surgical reform; provision of clinical redesign training, data analysis and support for hospital based surgical service redesign projects; development of key performance indicators and measures, including safety and quality measures; development of operational dashboards and reports to assist hospitals manage performance; targeted system wide projects and strategy implementation such as separation of elective and emergency theatre and establishment of a Central Referral Service. The introduction of Activity Based Funding has further strengthened health service focus on efficiency and effectiveness, capture of costing data, reporting and management of surgical and theatre activity.

Although WA Health have achieved significant improvements in patient access to elective surgery and are a consistent high performer for waiting times nationally, we acknowledge there are further opportunities for improvements in surgical services and theatre efficiency. This includes the report recommendations of improving performance monitoring, and access to reporting and data analysis support, and promoting further collaboration and sharing of theatre reform guidance and strategy between services and across the system.

The OAG’s report reaffirms the direction that Health has initiated for improving the elective surgical patient journey, including improvements in theatre efficiency. The recommendations are aligned with reform actively underway at Health Services and supported by Health. Given the scope and complexity of the ongoing reform requirements, expected implementation of all the recommendations is by July 2017.