Utilisation of paediatric surgical theatres at the Chris Hani Baragwanath Academic Hospital, Johannesburg

Abstract

Background. Optimal theatre utilisation is essential to reduce long waiting lists for elective surgeries and to increase cost-effective theatre operation. Utilisation rates well below the global benchmark of 80% have been reported for government hospitals in Johannesburg, South Africa (SA). Objective. To investigate utilisation of three paediatric theatres at the Chris Hani Baragwanath Academic Hospital (CHBAH) in Johannesburg. Methods. Surgery lists of the three theatres were reviewed for three one-week periods over a four-month study period. Preoperative, intraoperative and postoperative data were collected to create a timeline for each theatre and each surgical case, including reasons for cancellations, delays or expedited times. Results. A total of 152 surgeries were scheduled during the reviewed study period, of which 44 cases were cancelled. The utilisation rate was 59.8% across the three theatres combined, with individual rates calculated as 62.7%, 58.2% and 57.0% in the burns, general and neonatal theatres, respectively. The primary factor contributing to under-utilisation was early completion of the scheduled list. Surgery delays were mainly due to delays in transferring the patient to the theatre and between anaesthetic induction and the start of surgery. Conclusion. Utilisation of the paediatric theatres at CHBAH is below the ideal benchmark of 80%; however, utilisation was better than expected when compared with findings from other public-sector hospitals in SA. However, theatre efficiency was found to be very low and perhaps better explains the reasons for backlogs in paediatric surgeries at CHBAH.