1. © Copyright NHS Institute for Innovation and Improvement 2009 The Productive Series

2. © Copyright NHS Institute for Innovation and Improvement 2009 Cost effective care Team performance and leadership Safe and reliable care Patient’s experience & outcomes Principles of The Productive Series

3. © Copyright NHS Institute for Innovation and Improvement 2009 Critical factors for success with any Productive Leadership at Executive level√ Aligned with strategic direction√ Governance of the programme√ Continuous improvement√ Capability and knowledge√ Right people in place√ Source: NHS London Review May 2009

4. © Copyright NHS Institute for Innovation and Improvement 2009

5. The perfect operating list……..every list, every day, every patient Effortless for everyone Great team communication Quiet & smooth Fast but not rushed No glitches Safe, reliable care Finish on time…………… Building teams for safer care

6. © Copyright NHS Institute for Innovation and Improvement 2009 Efficiency data Over 8 weeks: Cost of cancelled, unused sessions £31,746 Cost of extra sessions £81,664

7. © Copyright NHS Institute for Innovation and Improvement 2009 % Session Utilisation Mean – 90% Mean – 99%

8. © Copyright NHS Institute for Innovation and Improvement 2009 Number of waiting list initiatives TPOT meeting reviews data

9. © Copyright NHS Institute for Innovation and Improvement 2009 Start, turnaround and finish times August 2008 June 2009

10. © Copyright NHS Institute for Innovation and Improvement 2009 Well organised theatre Overstock in main store room (4 theatres) resulted in financial reimbursement of £27, 500 Out of date stock in main store room (twin suite) valued at £9,385 Overstock in prep and anaesthetic rooms (2 theatres) valued at £10,400 Potential financial benefit for a twin theatre suite to make a ‘one-off’ saving of £24,150

11. © Copyright NHS Institute for Innovation and Improvement 2009 % compliance with team brief

12. © Copyright NHS Institute for Innovation and Improvement 2009 Problems avoided by Team Brief

13. © Copyright NHS Institute for Innovation and Improvement 2009 Impact on staff p<0.05

14. © Copyright NHS Institute for Innovation and Improvement 2009 “Since introducing TPOT there has been a noticeable change in culture …staff are clearly empowered to make changes” Consultant Surgeon Staff feedback In relation to team brief… “Giving people a voice means patient care improves, errors go down and morale goes up” Consultant Surgeon “Debrief is a terrific opportunity to give credit where it’s due and let people know they’ve done well. At the same time where lessons need to be learned it’s an ideal time to do so” Consultant Surgeon “Since TPOT everyone uses the data to evidence problems and measure improvements” Programme Lead “TPOT improves communication between theatre staff and clinicians” Theatre Sister “Well organised theatre has improved the organisation of stores and equipment which has had a direct impact on theatre efficiency” Theatre Practitioner “TPOT has had a positive effect on theatre team morale in the last 4-6 months. I think we are well on our way to achieve our primary goals of patient safety, team work and leadership” Consultant Anaesthetist

15. © Copyright NHS Institute for Innovation and Improvement 2009 Improvement drivers for key aims Value and efficiency 1 – main driver modules Reduced cancellations –Scheduling & patient prep –Operational status at a glance Improved utilisation and Reduced over-runs –Scheduling –Start-up, patient prep, turnaround, handover –Operational status at a glance Avoiding cost of defects –Team-working –Handover –Recovery Materials management –Well Organised Theatres –Consumables and equipment Value & efficiency Team performance & leadership Safety & reliability of care Patient’s experience & outcomes

16. © Copyright NHS Institute for Innovation and Improvement 2009 Value and efficiency 2 – benefit estimates (per annum) 174 trusts in the NHS Total of 2,871 operating theatres, Average 16.5 theatres per trust Per theatrePer DGH Reduced cancellations£ 23k£ 388k Improved utilisation & reduced over-runs £ 120k£1,980k Avoiding cost of defects£ 30.5k£503k Materials management £6k +£6k one-off £100k +£100k one-off Total£179.5 +£6k one-off £2,971k +£100k one-off

17. © Copyright NHS Institute for Innovation and Improvement 2009