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Establishing a £2.4m threatre efficiency programme

During the past 4 months the Four Eyes team have successfully worked with the operational and clinical teams at a hospital in the North of England.

The aim was to establish, implement and deliver a significant £2.4M theatre efficiency programme in Trauma and Orthopaedics (T&O). This would be achieved through improving ‘in-session’ efficiencies, increasing case-mix and changing individual surgeon list templates.

Given the Trust’s challenging financial position and significant variance of T&O performance to 2015/16 financial plan, this programme was needed to give them the necessary tools to get back on track. Ensuring savings identified in T&O theatres was a real priority.

  • Quick wins

    Following a rapid initial theatre review by Four Eyes, the team were commissioned to deploy the Four Eyes ‘Theatre Efficiency Delivery Programme’ with the aim of improving key operational processes. This involved the swift implementation of best practice scheduling and pre-assessment functions. This would enable the service to deliver an additional 700 cases through the ‘worked’ operating lists. This quick increase of in-session productivity also enabled the removal of additional pay costs over the 12-month period.

  • Outcomes

    The first steps of the programme involved deploying the Four Eyes scheduling tool, delivering training to the scheduling/booking personnel and working with the pre-assessment team. The Four Eyes team worked closely with the theatre’s department to strengthen key systems and processes.

    The Four Eyes programme delivered a rapid reduction in surgeon ‘downtime’ by over 50% through the implementation programme. The performance improvement enabled the service to hit all of its financial targets. This performance has been sustained and continues to be further improved.


  • Financial impact

    Having identified the case mix and volume required for the Trust to achieve its challenging financial delivery plan, the Four Eyes team have worked with the clinicians and managers on the ground to secure a significant and sustainable increase in productivity realising an additional £200k per month.

  • Sustainability

    The work with the Trust continues with our patient pathway level demand and capacity teams. Both of these aspects are vital to continued performance of the service. With the increased theatre productivity, the Trust needs the ability to maintain patient flow throughout the elective wards. The bespoke demand and capacity modelling ensures the unit has the right balance of staffing and resources for seasonal variation in referrals plus change in catchment population.