CUH cardiothoracic team adopts new ways to optimise ‘scarce’ resources

The data is contained in a blog post by CUH CEO Mr Tony McNamara, titled ‘Innovations in cardiothoracic surgery in Cork University Hospital’, posted in early August.

Mr McNamara cited the “scarce” theatre resources for cardiothoracic surgery at the hospital and noted ways in which the cardiothoracic team, led by three consultant surgeons, was trying to counteract this by optimising theatre time.

Their efforts have led to an increase in the number of primary lung resections undertaken at the hospital to date in 2018.

Until the end of March this year, the hospital was undertaking one-to-six procedures weekly and was regularly missing its target of four such procedures per week.

Since this time, it has consistently met its target of four weekly procedures and in many cases is performing six procedures per week, data supplied by Mr McNamara in the blog shows.

“In response to the continuous need to optimise the use of the scarce cardiothoracic theatre resource and to meet key performance indicators for thoracic surgery, the cardiothoracic department reviewed the internal processes for the use of theatres, following which changes were made, including the implementation of protected theatre time for primary lung resections,” he stated.

“As a result, there have been substantial improvements in the number of such procedures carried out in Cork in 2018.”

National Treatment Purchase Fund (NTPF) figures in January showed 308 patients were awaiting cardiothoracic surgery nationally, with just five individuals waiting over 18 months.

At the end of July, 379 patients were awaiting cardiothoracic surgery nationally, with 17 patients waiting over 18 months.

At CUH, 82 patients were awaiting cardiothoracic surgery at the end of July, compared to 65 at the end of January. There are six cardiothoracic centres nationally.

Mr McNamara stated that the service is acutely aware of the stress facing patients in advance of surgery. It has highlighted the need to reduce anxiety for patients pre-operatively and minimise trauma with the smallest incision possible, thereby shortening recovery time, among other issues.

To date, almost 70 minimally-invasive cardiac surgery procedures have been completed at CUH. This will rise to 100 such procedures by early 2019, Mr McNamara outlined.

“The emerging philosophy in the hospital is to support initiatives that focus on shortening the length of time patients spend in hospital pre- and post-surgery while actively promoting their recovery, thereby improving outcomes,” Mr McNamara wrote.