739 Pre-operative Holding Bay in Recovery - Preventing Delays and Improving Trauma List Efficacy

Aim The evidence from national productivity reports and available publications shows that multifactorial delays to operating start times prevail in Trauma and Orthopaedic theatres with a range of clinical and financial consequences. This Quality Improvement project was carried out to analyse the scale of the problem at our university hospital and to improve patient flow and Trauma Theatre efficacy by introducing a new Standard Operating Procedure to reduce delays in the start times of the morning Trauma Lists. Method The data was collected over a 6-month period using electronic records accessed through Bluespier Patient Manager. The agreed start time and arrival time for each first patient on the morning Trauma List were compared and a median delay time was calculated. Results The initial results showed a median delay of 30 minutes with the extreme being 140 minutes. The results were discussed with the Theatre, Anaesthetic and Trauma and Orthopaedic teams and a new Standard Operating Procedure was proposed and introduced. The implemented changes were threefold, the re-introduction of Golden Patient, sending for the patient prior to the morning brief and the use of a Recovery Bay as a Holding Bay for the first patient on the morning Trauma List to reduce the delays resulting from patient transfer. Conclusions Collected data confirms that delays in the start time of Trauma Lists are prevailing at Bristol Royal Infirmary. Further data will allow us to determine whether the new Standard Operating Procedure reduced them in a statistically significant manner.