Bridging Knowledge and Expertise to Improve Operating Theatre Turnaround Time Through Data-driven Process Optimization�
By
Kettice Mbugua APM, BScN, KRCHN
Olivia Ochieng BScN, RN
Aga Khan University Hospital, Nairobi
Why Turnaround Time Matters
PATIENT FLOW
Delays affect the movement of patients through the perioperative pathway.
THEATRE EFFICIENCY
Turnaround time influences theatre capacity and daily workflow(Pakhare et al., 2022).
TARGET
The quality improvement target is a 20-minute turnaround.
20 MINUTES
The target that guides the improvement work
2
The Problem
• Data were collected in real time.
• Collection and analysis were manual.
• Delays required follow-up after they occurred.
• Theatre status was not continuously visible.
• A sustainable automated solution was needed.
THE GAP
The information existed.��The challenge was making it visible, timely and actionable.
3
Quality Improvement Aim
1 MONITOR
Capture theatre performance in real time.
2 IDENTIFY
Detect delays and workflow bottlenecks.
3 IMPROVE
Support timely action and sustained performance.
ULTIMATE AIM
Keep theatre turnaround time at 20 minutes.
4
Measures Used
FIRST-CASE START
Timeliness of the first case
TURNAROUND TIME
Time between cases
BOOKED-TIME DELAYS
Where scheduled time was lost
STAFF READINESS
Readiness of the team
5
TAT Compliance
QI MESSAGE
Measurement alone is not enough.��Teams need timely visibility to support action.
7
Keeping the 20-Minute Target Visible
ON TARGET
≤20 min��Maintain flow
AT RISK
21–25 min��Escalate early
DELAYED
>25 min��Identify cause
SEE → UNDERSTAND → ACT
A continuous feedback loop for theatre performance
11
What the Data Showed
12,231
Phase 1 delay minutes
7,287
Phase 2 delay minutes
4,944
Minutes difference
KEY FINDING
The data highlighted delays linked to first-case starts, equipment availability and staff readiness.
Implementations
6
The Improvement: Automated Visibility
REAL-TIME
Data capture
AUTOMATED
Analysis
VISIBLE
Dashboard
ACTION
Follow-through
Dashboard successfully launched
Implementation is still in its early stage.
8
The 8-OR Real-Time Dashboard
One screen • eight operating rooms • one patient journey view
OR 1
OR 2
OR 3
OR 4
OR 5
OR 6
OR 7
OR 8
Pre-op
HH:MM
HH:MM
HH:MM
HH:MM
HH:MM
HH:MM
HH:MM
HH:MM
In OR
HH:MM
HH:MM
HH:MM
HH:MM
HH:MM
HH:MM
HH:MM
HH:MM
Start
HH:MM
HH:MM
HH:MM
HH:MM
HH:MM
HH:MM
HH:MM
HH:MM
End
HH:MM
HH:MM
HH:MM
HH:MM
HH:MM
HH:MM
HH:MM
HH:MM
Out OR
HH:MM
HH:MM
HH:MM
HH:MM
HH:MM
HH:MM
HH:MM
HH:MM
Status
OCCUPIED
VACANT
OCCUPIED
VACANT
OCCUPIED
VACANT
OCCUPIED
VACANT
Pre-op → In OR → Case start → Case end → Out of OR
9
Making the Patient Journey Visible
PRE-OP
Arrival time
IN OR
Arrival time
CASE START
Start time
CASE END
End time
OUT OF OR
Exit time
The dashboard makes each transition visible in real time.
This helps the team see where time is being lost.
10
Next Steps
OPTIMIZE
Improve dashboard usability.
VALIDATE
Collection of data to strengthen data analysis accuracy.
SUSTAIN
Track performance continuously.
FUTURE FOCUS
Analyse delays and follow the patient journey from ward to OR.
12
Conclusion
“Alone we can do so little; together we can do so much.”� — Helen Keller
Together, we can turn every minute saved into better patient care.
References