Enhancing flow in trauma theatre


Medway NHS Foundation Trust implemented a quality improvement project to enhance the flow in trauma theatre.

The trauma theatre had a challenge of late first case start times, which affected flow, efficiency and productivity. 

How did they make improvements

Medway NHS Foundation Trust implemented a newly formulated trauma policy (SOP), which included an improvement to the first patient start time. This involved identifying and preparing the first patient the day before (‘golden patient’). This in turn had a positive effect on flow and productivity of the trauma theatre.

Initial findings

  1. The initial audit cycle October 2014 to March 2015 showed identification of golden patient in 67% of cases
  2. The trust saw significant improvement to the first patient start times when golden patient was identified


  1. When comparing first patient start times before and after implementation of the trauma theatre policy, it showed significant improvement in start times
  2. The improvement is more so when a golden patient was identified and reviewed beforehand
  3. An improved collaboration between anaesthetic and orthopaedic/trauma teams

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