Developing and implementing a Theatre booking tool for Major Trauma cases requiring emergency surgery: enhancing the planning, preparation and handover processes
The unpredictable and dynamic nature of major trauma care requires strong leadership skills, effective teamwork and robust communication processes within and between different multi-professional teams along the trauma care pathway.
At Nottingham University Hospital (NUH) major trauma patients requiring emergency surgical management have to be prioritised alongside other patients booked for emergency operations. This creates competition for resources which have to be allocated quickly and seamlessly despite conflicting demands. This process will be aided by the Theatre Co-ordinator having correct and appropriate information about patients in ED undergoing rapid assessment in order to determine the need for immediate or urgent surgical intervention. We aimed to evaluate the existing theatre booking process for major trauma patients, identify key problems in practice, and redesign and test any new system prior to implementation.
Questionnaire data and focus groups with theatre staff, surgeons and anaesthetists (n=84) distinguished critical versus surplus information for theatre planning, enabling redesign of the form, structured using key information in a chronological systematic manner
This information was used to produce a new form highlighting essential areas in a chronological and logical organisation to aid planning and preparation of theatre. Quality of care was found to be dependent on staff experience so the new form is designed to standardise the transition of care.
The new form is now being tested using desktop simulations based on real cases with theatre coordinators, comparing useability and accuracy of data transmission with the generic form. This will guide further modifications before trialing it in practice. Further steps anticipated include production of a standardised handover proforma to be implemented in the Emergency Department, and evaluation of whether the final theatre booking form also provides a team briefing tool for when the patient arrives in theatres.