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INFRASTRUCTURE
prolonged procedure affecting subsequent
procedures, under utilisation of OT re-
sources, disappointment of both doctors and
patient attendants, delayed opinion from
co-consultants result in delayed decision
making and delayed start of the procedure
by the doctor.
The main reasons for delay in operations
range from blocking of OT by doctors in an-
ticipation of patients, doctor’s preference to
complete the procedures before his evening
clinic, misfit of the patients due to sudden
illness or variations in the parameters, wait-
ing for the insurance approval. Also, factors
such as non-availability of implants, prosthe-
sis in the required size/brand at the required
time, non-availability of instruments/equip-
ment due to emergency, sudden breakdown
of the biomedical equipment, non-availabil-
ity of OT at the required time, non comple-
tion of documentation like consent forms,
longer lead time between the procedures
also lead to delay in operations.
What are the main reasons for cancella-
tion of operations from the hospital side?
This ranges from non clearance from insur-
ance companies or TPAs, sudden breakdown
of bio medical equipment, insufficient infra-
structural facilities (water leakage, break-
down of AC system etc), non availability of
required size/brand of implants/prosthesis,
sudden absence of the doctor/anesthetics.
So, how can one improve OT utilisation?
Proper OT scheduling will bring discipline
in OT. This means allocation of OT on first
come first service basis. Before booking,
having proper check list on various clear-
ances will reduce cancellations. Unless
there is an emergency, only doctors who
were allotted ‘OT days’ should be given pref-
erence while booking. Encouraging planned
procedures to do in the nights to avoid
rush in the day time. To attract doctors
to do surgeries in the night, either we can
increase the doctors fee or give discount for
patients. This will improve the utilisation of
the OT resources. OT 'start' timing should be
strictly followed.CASE STUDY: KMCH, COIMBATORE
The no of OTS: It has 25 OTs. All of them are state-of-the-art OTs
with strict compliance on requirement.
How functional are these OTs: They run throughout the year. Once
in three years each complex will be closed for 15-20 days during the
lean period.
How many surgeries are conducted per day: Approximately 55-60
per day in 26 days of a month.
What is the time between the surgeries: 45 – 60 minutes.
What is the total operation time utilisation: 70 – 75%.
How many cancellations of surgeries happened last year and
what were the main reasons: On an average, five cases per day.
Mainly due to clearance from insurance companies or change of mind
of relatives. Other reason would be due to patients being misfit due to
sudden change in vitals.
What were the reasons for delay in surgeries: Blocking of OT
by doctors in anticipation of patients. Misfit of the patients due
to sudden illness or variations in the parameters. Waiting for the
insurance approval. Change in attendant's decision for clearance.
Non-availability of OT at the required time. non completion of
documentation like consent forms. Delayed investigation reports for
which doctor is waiting for decision making. Patient more particular
about auspicious day and time for which OT is not available.2