Audit of emergency theatre utilisation

Abstract

This audit was undertaken to assess the utilisation of the emergency theatre in University College Hospital, Ibadan. It was also to find out if there was effective use of the emergency theatre space on a daily basis. Data was collected on all patients scheduled for emergency surgery excluding obstetric emergencies between May 1 st and July 31 st 1999. A total of498 patients were booked for emergency surgery during the study duration and out of these, only 198 patients [38%] had their surgery performed. The number of patients booked per day ranged between 1 and 18 (Mean + S.D) [5.4 ±4.1], while the number operated ranged between zero and 9 (2.2 ± I 7). The General Surgery Unit had the highest number of cases booked (31.1 %) and performed (38.9%). However, all the patients booked by the Gynaecological Unit (4.8% of total) were operated upon. Time interval between time of booking and the beginning of surgery ranged from 30 to 990 minutes (431 ± 296.7), while duration of surgery ranged from 25 to 750 minutes [121 ± 96.5]. Theatre utilisation during this study was between 5 to 50% (mean 26.9%) and the period of maximal utilisation was between 16.00 and 03.00 hours. Reasons why surgery was not performed on all (100%) booked patients included among others "Surgeons did not show up" (62%), "Surgery postponed by surgeons" (18%) and "Patient ill prepared for surgery" (10%). This study showed gross under-utilisation of emergency theatre space with contributing factors mainly human and preventable.