1Operating Theatre Management System (OTMS)- first year experience with OT time capture

2Background

In view of high risk and resource intensive nature as well as the huge workload of the operating theatre, Operating Theatre Management System (OTMS) was initiated to develop in year 2000 with an aim to bring about significant improvement in:

patient care process resource management efficiency of OT

3Objectives

To improve the quality of patient care and services through information sharing among different disciplines during the

patient care delivery process. To assist management in resources utilization by providing

OT management real-time information on status and schedules of all theatres.

To improve the staff productivity by saving time in compiling statistics report and searching information. For example, average elective major OT waiting time.

4Dr. Joseph LUICOS(Ana)/CMCCo-Chairman

Dr. C. YEUNGCONS(SRG)/QMH

Co-Chairman

Dr. Wallace CHIUCOS(ANA)/PYNEH

HKEC

Dr. Theresa HUICON(ANA)/QMH

HKWC

*Dr. Y.F. CHOWCCOS(ANA)/QEH

KCC

Dr. H.K. CHENGCOS(ANA)/TKOH

KEC

Dr. Joseph LUICOS(ANA)/CMC

KWC

*Dr. K.M. HOCON(ANA)/NDH

NTEC

Dr. T.W. LEECOS(A&IC)/TMH

NTWC

Cluster Representative

Dr. C.K. WONGCONS(NEU)/PYNEH

HKEC

Dr. C. YEUNGCONS(SRG)/QMH

HKWC

Dr. H. K. WONGCOS(O&G)/QEH

KCC

Dr. S.H. LAMCOS(Surg)/UCH

KEC

*Dr. John KWOKCOS(Neuro)/KWH

KWC

*Dr. P M YUENCON(O&G)/PWH

NTEC

Dr. Y.Y. CHOWCOS(O&T)/TMH

NTWC

Cluster Representative

Mr. Alick CHIUDOM(OT)/NDH

(Nursing)

Dr. S. W. TSANGCOS(GYN)/TKOH

(O&G)

COC Representative

Dr. N.T. CHEUNGEM(HI)/HAHO/ITD

Mr. Anthony CHEUNGSSM(CS)/HAHO/ITD

Mr. Tony FUNGSM(CS)3/HAHO/ITD

(Secretary)

Ms Ellen TONGM(CD)5/HAHO/ITD

/

OTMS Steering Group

5OTMS Project ScopePhase 1 : 4 years project 03/04 06/07

Development Phases a. Elective booking module b. Emergency booking module c. OT Activity tracking module

Implementation 14 acute hospitals 9 major surgical stream departments

Statistics Total no. of OT room in HA = 200 Total no. of Operation Booking / year = 250,000

6ElectiveEmergencyCross HospitalsOT List Patient Tracking

Suites Status EnquiryUtilization ReportsCase Record ()

Pre-assessmentIntra-op Anaesthetic RecordPost-assessmentNursing recordAnaesthetic record

Anaesthetic machinesEIS / Data warehouse

HAHO Monitoring ReportsStandard ReportsAd hoc ReportsData ExtractionAverage Elective Major OT waiting time

OTMS Functions & Architecture

Phase II Phase I

7Progress StatusOTMS Phase 1a, 1b, 1c planned and actual implementation schedule as at end of April 06

Planned Progress Planned Progress Planned Progress

HKWC QMH 03/04 Completed 04/05 Completed 05/06 Completed

NTWC TMH 03/04 Completed 04/05 Completed 05/06 Completed

UCH 03/04 Completed 04/05 Completed Aug-05 Completed

TKO 03/04 Completed 04/05 Completed Aug-05 Completed

CMC 03/04 Completed 04/05 Completed Jan-06 Completed

KWH 3Q 06 Completed 2Q 06 Completed 2Q 06 Completed

PMH 1Q 06 Commenced for O&G,NEURO

Aug-05 Completed 3Q 06

YCH 03/04 Completed Sep-05 Completed 3Q 06

KCC QEH 3Q 06 3Q 06 3Q 06

NDH Nov-05 Completed Jun-05 Completed May-06PWH Mar-06 Commenced for O&G, ENT,

NS4Q 06 4Q 06

AHN Mar-06 Commneced for O&G,Surgery, ENT

N/A N/A 4Q 06

PYN 03/04 Completed Sep-05 Completed 2Q 06

RHTSK 03/04 Completed Nov-05 Completed 2Q 06

HKEC

NTEC

KEC

KWC

Emergency OT Booking(Phase 1b)

Proposed Live Run Date

OT Theatre Time ActivityManagement (Phase 1c)

Proposed Live Run Date

Cluster Hospitals Elective OT Booking(Phase 1a)

Proposed Live Run Date

8Elective Booking - Weekly View

9Emergency OT List

10

Statistical Reports

Emergency OT Utilization

Elective waiting time (waiting time)

Usage report

11

OT Activities Time

12

OT activities time & definitions

13

14

First year experience

Need for benchmarking Local / overseas Improvement

15

OT activities time & definitions

Induction time

16

OT activities time & definitions

Turn around time

17

OT activities time & definitions

Transport time

18

First year experience - conclusion

Initial statistic report on OT time revealed confusing results

Range:- 30 to 140 minutes (induction time)- 10 to 120 minutes (turnaround time)

19

OT activities time & definitions

Anaesthetist inserts an IV cannula in patient

in Day Surgery Unit

20

OT activities time & definitions

Surgeon puts in a Foley catheter

Before Anaesthetistinduces

21

OT activities time & definitions

Conversion of spinal anaesthesia

To GA after incision of skin

22

OT activities time & definitions

Patient returns toOperating Theatre

For control ofbleeding

23

First year experience - conclusion

More precise definition on specific times is required Regular training of frontline is important

24

OT activities time & definitions

Anaesthetist control time

25

OT activities time & definitions

Surgeon control time

26

OT activities time & definitions

Nurse control time

27

OT activities time & definitions

Supporting Service Control time

28