Theatre Schedule Management Challenges & Strategies - Academy
Exploring ways to improve your theatre schedule?
Good operating theatre schedule management can help you understand theatre capacity, improve theatre efficiency, and make the most of theatre capacity and surgeon time to treat more patients.
Optimising theatre schedules can play a significant role in reducing surgery waitlists and improving wait times for patients. But theatre schedules aren’t always managed in a way that enables capacity to align with demand, for a number of reasons.
So, let’s explore some challenges that might be impacting your theatre scheduling processes — and what you can do to improve your systems. But first, let’s begin with a basic definition…
A theatre schedule is a tool typically created and managed by Nurse Managers and used by surgical staff and hospital management. They show:
- The number of theatres
- The number and duration of lists (for example, across 8 theatres, we might have 14 lists, with durations from 8:00am-12:00pm or 8:30-5:30pm)
- Which specialty each theatre is allocated to (for example, maxillofacial or vascular)
- The consultants and operating surgeons assigned to each theatre (and when)
While they all include the same general information, different hospitals display and manage their theatre schedules in different formats — and this is part of what makes the schedule more (or less) challenging to manage.
1. Paper and Spreadsheet Systems
Many hospital organisations haven’t yet seen the value in or invested in an electronic schedule. This means that many theatre schedules are still produced and displayed on Excel Spreadsheet (or even pdf printouts).
Of course, Excel has the advantage of being a very familiar tool for most users, in a software that’s readily available on most computers. And it can sometimes work well if there’s a perception that very few people need to see or have edit access to the schedule.
But as demand for hospital services increase and as clinical teams are increasingly held accountable for managing their own performance, a spreadsheet-based system becomes very limiting for a number of reasons:
- Difficulty analysing the data – Particularly when it comes to seeing demand and capacity together so that teams can make informed decisions about allocation
- Version control issues – If spreadsheets are sent via email and then changes are made to the schedule, some staff may not have an up-to-date version of the schedule and/or changes may be lost, leading to booking and attendance issues
And of course, there are all the usual limitations that come with paper-based systems, like:
- Delayed access – Staff cannot access the information or make data-driven insights in a timely manner
- Limited visibility – Staff need to be physically present in the department in order to see the schedule and inform their delivery plans
2. Master Schedules That Don’t Match Demand
A master theatre schedule is usually set up well in advance (often quarterly) and used to guide planning and staffing. It broadly outlines the allocation of lists, but does not take into consideration things like leave and equipment requirements. The master schedule is used for roster planning, as it gives doctors a general idea of what days they’re required to work — which is especially important for those that work part time or are a visiting medical officer (VMO).
The downside of having a master schedule set so far in advance that it makes it difficult to be agile and respond to surges in demand. This is especially problematic for specialties that have a high throughput, high acuity case load, like urology and general surgery.
What often happens is that more time is allocated to these teams than what may be actually required. In other words, the master theatre schedule may overcompensate for demand in some specialties. Most of the time, the extra time is used to manage surges in urgent cases and to prevent routines from being cancelled. And it can also be redistributed to other specialties closer to the time (and this change is then reflected in the actual schedule).
However, when the master theatre schedule doesn’t reflect what is required based on the waiting list, it can make theatre schedule management more challenging for hospitals that are working to match theatre capacity with demand.
3. Allocation Based on Influence
Finally, another issue that comes up is what we sometimes refer to as the ‘elder statesman’ effect. Similar to other types of organisations, some people in hospitals have more influence than others, often as a result of their time spent in the role, their position within the department, or the urgency of their work. And for some surgical consultants, this kind of influence can enable them to secure theatre sessions that are not always required, or theatre time that doesn’t necessarily align with the demand for their specialty.
This is something we see frequently. But it’s incredibly hard for teams to avoid or change this practice if they don’t have the information they need in order to show the impact it might be having — and how it might be preventing the hospital from treating all the people that require care.
Digital transformation in healthcare systems is inevitable — and part of that process includes digital theatre schedule management systems. More and more hospitals are introducing electronic medical records (EMR) and modern operating systems. One system that’s becoming increasingly common is the Electronic Operating Theatre Schedule.
Like a spreadsheet or paper system, an electronic system allows staff to see the number of theatres, the specialty and doctor allocated, and all of the information necessary to understand how theatre time is being allocated. On top of that, it can provide data and insights that enable teams to structure their schedules around demand.
For the first time, teams can see actual demand (operating time needed) alongside theatre capacity, by integrating data from an electronic schedule, waitlist data (the people who are waiting) and theatre management data (like historical operating times). And as a result, they can truly manage demand and capacity.
Other benefits and capabilities include:
- Being able to see time available and suggesting appropriate patients who may fit on the list
- Optimising theatre and surgeon capacity to treat more patients and reduce the backlog
- Reducing the likelihood of human error associated with manually analysing theatre demand and capacity to develop lists
- Allowing staff to access their schedule and waiting list in one system — providing a single source of truth that’s secure, always up to date, and access-controlled
Did you know that SystemView includes a component specifically designed to support theatre schedule management?
Inside SystemView, go to:
Surgery > Elective Schedule Monitor
Inside this component, you’ll find charts that show the Total Theatre Minutes Booked Next 6 Weeks, allowing you to easily visualise booked/available/overbooked theatre time. You can also filter by facility, especially, doctor, session type, and session day.
Click on the chart for a specific week to see a detailed breakdown of minutes booked across each individual theatre for each day, with sessions divided into all day, AM, and PM.
Then click into a chart for an individual session to open up session booking details and see a list of booked patients. If you have available minutes remaining for the session, you can view a list of elective patients within 6 weeks of target treatment with procedures estimated to fit within the session. Plus, elective patients within 6 weeks of target treatment that have longer procedures.
The Elective Schedule Monitor component supports future theatre capacity planning, while suggesting patients that could fill any remaining theatre time at a doctor level.
Interested in learning more about how you can optimise your surgical department or theatre scheduling? Uncover more challenges and strategies for hospital surgical departments in our Surgery Fundamentals Guide [insert hyperlink whenr eady].
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