Delays to Operating Theatre Lists: Observations from a UK Centre

The aim was to measure the incidence of delays to operating theatre lists and the reasons behind them. A cost implications analysis was also performed to discover the potential savings to be made from improvement in this aspect of theatre efficiency. Prospective surveys recording start-time delays and total daily delay during 227 multiple-specialty cases were completed over five days in March 2010 in a UK District General Hospital, split over two sites. Information was collected onto a proforma for each case about specialty, procedure, start-time and end-time of the case, with request for an explanation for duration and reason for any delays incurred. An analysis of costs to the Trust was performed using estimated theatre hours lost with average cost of theatre use per hour.Overall 78% of cases started on time, i.e. within 15 minutes of the scheduled time, but orthopaedics and plastics achieved only 69% and 66% respectively. Orthopaedics and plastics also exceed the acceptable total daily delay time of 45 minutes (70 and 66 minutes respectively). Hospital-wide factors were the most common reason for the delays (72%). 48% were due to ward bed issues, 15% due to doctor factors and 13% inadequate pre-operative assessment. Estimated projected cost to the Trust over one year is significant at over £1 million ($1.5 million).During the study period, theatre time was lost for usually multi-factorial reasons, with hospital organisational factors being predominant. Opportunities to improve theater efficiency were identified.