Title : Straight to theatre: A quality improvement project assessing the impact of an escorted patient walking intervention on transfer delays
Abstract:
Delays in transferring patients from the ward to the operating theatre can have a significant impact on surgical efficiency, contributing to wasted theatre time and potential case cancellations. This quality improvement project aimed to identify causes of delay in transferring patients from ward to theatre and implement an intervention to reduce transfer time without compromising patient safety or workflow. A retrospective audit was conducted over a three-week period in February 2025, including 244 elective and day case patients. Data collected included the time patients were sent for, arrival at the receiving theatre, anaesthetic start, and surgical start times. Anaesthetic and surgical durations were considered non-modifiable, focusing instead on transfer delays.
Following review, an intervention was introduced allowing patients to walk to the theatre reception under nursing supervision instead of waiting for a porter (1)(2). The initial audit demonstrated a mean transfer time of approximately 22 minutes (range 2–64 minutes), equating to a cumulative time loss of approximately three days and five hours. Post-intervention data showed a reduction in the mean transfer time from over 22 minutes to approximately 17 minutes, This corresponds to a 22.7%decrease compared with baseline, thereby meeting and slightly exceeding the initial 20%reduction target reflecting a measurable improvement in theatre efficiency and a reduction in total lost operative time.
Table 1: Comparison of ward-to-theatre transfer times before and after intervention
|
Cycle Mean Transfer Time (minutes) Range (minutes) |
|
Baseline Audit (Cycle 1) ≈ 22 2 – 64 |
Introducing assisted walking for suitable patients led to a modest but meaningful reduction inward-to-theatre transfer delays. This low-cost, practical intervention improved patient flow and theatre utilisation. The re-audit indicated that the escorted walking protocol saved 1,220minutes of theatre time, which, if sustained, would reclaim 17 operating days annually.
1. NHS England. Operating Theatres: Efficiency and Utilisation Guidance. 2023.
2. GIRFT Programme. Orthopaedic Elective Surgery: Guide to delivering peri-operative ambulatory care for patients with hip and knee pain requiring joint replacement surgery.
