How to Operate 3x Faster
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- Опубліковано 3 лип 2024
- I was involved in the development of a system that has significantly increased the efficiency of NHS theatres. Prior to implementing this system, we were only able to perform 8 tonsillectomy operations in a day. However, with the new system, we are now able to perform at least 26 tonsillectomy operations in the same time.
Since successfully implementing this system at our hospital, we have been able to increase the number of skin cancer and urology operations by three times. We have also shared the data with NHS England, and many other hospitals across the country have started implementing this system to reduce waiting lists and provide better care for patients.
I explain the details of this system and how it can be implemented in other hospitals to improve efficiency and patient care.
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Chapters
0:00 Introduction
0:12 Mark Churchill Theatre Matron
0.39 How to operate on more patients
0:51 Operating vs anaesthetic time
1:07 How we currently process patients in theatre
2:16 The problem with how we do things
2:36 Why you should not operate faster
3:01 How we changed the process to speed up theatre
4:29 Double the anaesthetists and nurses
6:07 Do not try and operate fast - no shortcuts
7:50 You are just a quick surgeon - this is not possible here
9:12 Trial run with all surgeons in department
11:18 The hospital benefits from 3 x lists
12:08 How much money the hospital made
12:45 Working 3 x as hard on the NHS
13:33 Why I do these lists
15:31 This works for other surgical specialties as well
16:11 Wrapping up
16:33 Photo of the team after a hard day's work
16:36 Conclusion
** Disclaimer - The information in this video is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace a consultation with your own doctor/health professional. ** - Наука та технологія
Amazing doctor can't wait for my surgery on 3rd April
Thank goodness for surgeons like you. I hope they can get this working throughout all departments in the NHS.
Very good to see a professional trying to improve the usage of operating theatres.
Does anyone remember the TV series with businessman Gerry Robinson many years ago, where he realised the large amount of time theatres spent being unused - and coming up with suggestions to hopefully improve the situation......I don't suppose they were ever implemented?
Yes I remember it well He had a lot of opposition sadly
Really good to know that doctor’s are trying and coming up with real solutions that make a difference to patients. Other proffesionals in the NHS, such as nurses and assistants on wards need to do the same.
Great video. Inspiring
Thanks so much!
Thanks for making this video. This is so helpful for patients who view the whole NHS from the outside as a monolith of despair. It makes us appreciate the effort and logistics behind the scenes. As someone who is still on the waiting list with no idea when my turn will be (this year or next, or never), I am really excited by this, and I hope this system is implemented ASAP at the Royal National ENT and elsewhere.
I work in an endoscopy clinic. We have a pre/post op area where the nurses bring in a patient, vital signs, medical history and medication and establish the IV. We have 22 bays divided by a flimsy curtain. Physician is assigned a procedure room. The patient comes back to their room after the procedure and is recovered from anesthesia there. We're using propofol. The procedure room is resanitized between cases. The doctor comes out to talk to the patient regarding findings (before DC'd home with their driver) between cases while room is being sanitized and setup for next procedure.
Those endoscopy suites are far more effective than theatre suites on average.
Very admirable - doing more work forthesame pay for NHS
First yet again Dr Vik Veer! Amazing as always and looking forward to the next one !
Congrats!
USA - On Thursday I was the first case of the day for a stapedectomy. I arrived at 0600, signed papers, and was taken back by two nurses who prepped me, IV start. NA and AMD came, checked my mouth and briefed me. Surgeon came and signed my neck. Chief resident answered questions. Surgical nurse answered more questions.
NA wheeled me from pre-op suites (20 beds), to operating theater. Start time 0730. Done 1130. NA and AMD handed me off to Post-anethesia care unit (PACU), caught their next patient.
Being a 4 hour procedure, the "quick" model probably wouldn't work for an otologist.
This really is a very straight forward and logical innovation that is good for the NHS and making the best use of resources.
It makes sense to try and fill up the “idle” time where possible.
It makes sense now why I spoke with two different anaesthetists during my tonsillectomy and pharyngoplasty
Curious to learn Dr Veer do you do the same when doing private work?
I don't do it privately (too difficult to set up), and I don't do it at the RNTNE (again too difficult at the moment). You spoke to the Consultant and the junior doctor when you came over.
We did this in the 60’s in all our theatres
It worked then
What happened?
Please help, I have a perforated ear drum I fell like a have a lump inside my ear.When I smile i feel a pulling dragging feeling inside ear and down side of neck under ear.So uncomfortable.would would be grateful for your advice.I have perforated ear drum. On antibiotics ear drops 14 days. Your knowledge is 100 percent and the way you explain is so easy to understand amazing.
Vick I've still got the Tinnitus and Hyperacusis. 1 year now. Might have to have a few drinks to calm it down. Worse when tired. Wtf.
I think you ought to ]see a doctor who specialises in this condition - I wish you the best.
I was recently in A&E and had to have an x-ray and CT scan (am fully ok BTW) and there were a few at a time taken along as a small batch.
I worked in the print trade and we would batch jobs on the same paper, could print a few short jobs one after another. Similar principle.
Edit to add: this should be standard in the NHS, dunno why it isnt?
Hi, thanks for sharing. Hope all other hospitals adopt your system. How long do DISE take, how many do you do a day?
A DISE takes about 25 minutes of me watching a patient sleep. The whole event takes about 45 minutes with the anaesthetic as well. It takes a long time to write up and explain what I found in a DISE afterwards - So I only do about 6 a day and mix in other longer operations in there as well.
@@VikVeerENTSurgeon makes complete sense to time save where possible, I’ve been in the recovery room for over an hour sometimes until pain is under control and the anaesthetist has been fleeting in and out between surgeries to see me.
Do you adopt the same time saving system when performing the DISE? looking forward to my DISE and finding out the results when it’s my turn. Let’s hope the nhs can bring down waiting lists!
Sadly so few anaesthetists are able to perform a DISE correctly, I don't have the luxury of this method for that operation. Most people just don't get it.
It be time saving but sometimes it can be difficult and risky.
How long will the patient remain unconscious, does it depend on the amount of anesthesia? Are all patients given the same anesthesia for a particular surgery?
Does elevating your head help relieve back-based sleep apnea? I have a mandibular device and my doc says back-sleeping is when my sleep apnea is worst. i've heard that elevating one's head helps. I've heard that "sleep number" beds help folks sleep better. Thoughts on beds and elevating one's head would be helpful.
Hi Vik, another very informative video as always!
On my NHS/APP-got both my appointments through to see you one is the post op for my turbinate reduction/possible Eustachian Tube Dilation as still getting crackling/popping in ears-think I may need CT scan of both my ears!
Post-op is for 15th at 3:15pm-how comes I need that as I' m having local anesthetic??
How long will it take about 15 mins??
then my operation is - Thursday the 21st of March at: 12:30pm-Got my letter for the 21st but not for the 15th but not to worry as I have written the 15th one down and on my NHSAPP.
Reply when you can Vik cheers 👍🏻
Have you ever toured a surgical center in Houston, TX?
I have only ever been to New York for work, sorry. No where else in america.
I don't believe it is possible in american hospitals because you don't have an anaesthetist's room.
What happens when there is an unexpected or catastrophic incident in theatre that requires significantly more time to deal with, or the surgeon cannot continue operating (illness, trip/slip), or the theatre becomes unavailable(equipment fault, electrical issue) while there is another patient anesthetised waiting on standby? Is that patient sent to recovery without an operation and will you be able to justify to that patient and legal people the risk of anesthetising the patient without actually performing any surgery on him/her.
I had septoplasty yesterday didnt kno they stick a tube down the throat 😅
Hopefully I will get to experience this soon as finally got my Dr after begging for 2 years to refer me to you as Bristol sleep apnoea care is rubbish. Give you a cpap or mandipula device then never see you again. 😢
ARE YOU SERIOUS ILL QUIT IF I WORKED THERE BAD MANAGERS