OT Committee Meeting ( 21/9/2012)

|Apollo Hospitals, Bhubaneswar

Main Agenda

• 1. To Improve OT utilization

• 2. To Save precious OT time

Study Period -June, July, Aug’12

|Apollo Hospitals, Bhubaneswar

Last Meeting- June 27th 2012

Issues Discussed & Status 1 OT Data Numbers and Procedures are being recorded separately

OT timings, delays and TAT are being recorded and analyzed 2 Noise in OT Acceptable level 3 Surgery recording Open surgery recording system to be purchased for OT-1.- Pending 4 C-Arm & Lap Set Under process- C arm has come, Lap set pending 5 Trainee Nurses

in OTAll Trainee nurses in OT has to be replaced by registered nurses is not yet done (Registered 18 (3 on long leave), Trainee-13 (4 on long leave)]

6 C-Sect OT Modifications to be done to separate the toilet area & make provisions for OT pharmacy & OT store is completed

7 C-Sect OT Table Some attachments are required. Local fabricator may be explored to provide the same. This is pending

8 OT Technicians One or two technicians are weak performer- they are being posted with experienced staff. 3 more OT technicians have to be recruited.

9Neurosurgery scheduling Three days a week Neurosurgery will get preferential first slot in OT-3. This is not

implemented due to lack of consensus, however the posting is being done by mutual adjustments.Use of OT-2 for Neuro/Ortho cases is being done only after permission of Dr R N Mohapatra.

|Apollo Hospitals, Bhubaneswar

10 Sample receiving in Lab. Provisions are to be made to receive samples in all labs from OT has been made by Dr. Dipika.

11 Dining Room in OT Dining room is completed & furniture has been placed.

12 Outsiders inside OT No outsiders (Doctors/Relatives) related to the surgery being performed is allowed inside the OT.

13 Software for Anaesthesia record keeping

We are continuing to work with the old software. No one was sent to Delhi to get the software.

14 Instrument Purchase Pending instrument replacement from last year is yet to be completed.

15 Neuro Instruments Wilsons frame & Codman lumbar Retractor newly purchased are not functioning and needs to be replaced.

16 Intubating Naso-Laryngoscope As requested by Anaesthesist 6 months ago is still pending.

17 OT Secretary Secretarial service in OT is being provided up to 8pm.

18 Instrument Trolley 11 trolleys have been purchased recently.

19 Nursing deployment in evening hours

No shortage of nursing staff but shortage of skilled nursing manpower.

20 Need for emergency OT Emergency OT will be developed after NABH inspection

21 Overtime issue Same overtime payment among nurses/ technicians `

|Apollo Hospitals, Bhubaneswar

Total OT Utilization for the month of June, July & Aug'2012

June July Aug0

10

20

30

40

50

60

70

80

54%

65%

71%

Total OT Utilisation for the month of June,July & Aug'2012

|Apollo Hospitals, Bhubaneswar

OT WISE UTILISATION(in %) FOR THE MONTH OF JUNE - AUG’2012

OT-1 OT-2 OT-3 OT-4 C-sect0

10

20

30

40

50

60

70

80

90

100

62

32

79

73

21

79

57

79

85

22

79

60

92

83

40

June

July

Aug

|Apollo Hospitals, Bhubaneswar

Total number of Surgeries & Patients ( June- Aug’12)

JUNE JULY AUGUST0

50

100

150

200

250

300

350

400

450

320

378 381

309

367 368

TOTAL No.OF CASES

TOTAL NO.OF PATIENTS

|Apollo Hospitals, Bhubaneswar

Total No. of Surgery Dept.wise for the month of June,July & Aug'2012

Cardio

Tho

racic

Sur

gery

ENT-Hea

d & N

eck

Surge

ry

Gener

al Sur

gery

Lapa

rosc

opic

Surge

ry

Neuro

surg

ery

Obste

trics

and

Gyn

ecolo

gy

Lapa

rosc

opic

Gynec

ology

Surgic

al Onc

ology

Ophth

almolo

gy

Orthop

aedic

s

Paedia

trics

Sur

gery

Plastic

Sur

gery

Urolog

y

Lapa

rosc

opic

Urolog

y0

20

40

60

80

100

120

140

160

180

92

31

84 82

110

83

33

60

81

163

15

89

46

110

Total No. of Surgery Dep-t.wise for the month ...

|Apollo Hospitals, Bhubaneswar

Major causes for OT delay

Late arrival of

Surgeon &

Previous case

prolongation is

contributing

largely as a

cause of Delay

Scope of

improvement –

Minimizing the

late arrival of

Surgeon,

anesthetist and

encourage them

to give proper

estimation of OT

duration

Others Includes

Equipment not available,

Incomplete preparation,

Financial constraint , Clinically Unfit etc

Ane

sthe

tist

cam

e la

te

Em

erge

ncy

case

/ ca

se r

esce

dule

d

Day

care

pat

ient

cam

e la

te f

or a

dmis

sion

Pre

viou

s ca

se p

rolo

ngat

ion

Sur

geon

cam

e la

te

Oth

ers

Reason for Delay in OT (June- Aug'12)

0

10

20

30

40

50

60

148

4

2634

1815 15 17

45 48

1216

6

18

37

58

11

June

July

Aug

|Apollo Hospitals, Bhubaneswar

Percentage Contribution

OT secretary gives reminder call to the patient posted for first case in

order to avoid late arrival and therefore causing delay in surgery resulted

in lower trend for the month of June

11

7

10

27

35

10

Reason for Delay in OT (June- Aug'12) % Con-tribution

Anesthetist came late

Emergency case/ case resceduled

Daycare patient came late for admission

Previous case prolongation

Surgeon came late

Others

|Apollo Hospitals, BhubaneswarApollo Hospitals, Bhubaneswar

THAN K Y OU