The Productive Operating Theatre programme TPOT housewas a modular programme created by the Institute for Innovation and Improvement in 2009 for theatre teams across the NHS.  The aim of the programme was to improve quality and safety in theatres, and was part of the Productive Series.  The programme has been adopted by national and international health organisations such as Scotland, Ireland, Wales, Northern Ireland, Qatar, New Zealand, Australia and Denmark.  Here you will find the modules relating to TPOT.

There are three main areas to the programme, which will contribute to improved outcomes and experience for the patient:

  • increase the safety and reliability of care
  • improve team performance and leadership
  • Add value and improve efficiency 

With this set of aims the programme appeals to all staff, from nurses to finance directors, from consultants to porters.  The programme empowers and engages front line theatre teams by harnessing their desire to deliver safe, reliable, high quality care, to use innovation in process redesign and to become more productive as well - working smarter not harder!

The Productive Operating Theatre is comprised of two leader's guides, 11 modules and a toolkit.  

Executive Leader's Guide - The guide helps executive leads to mobilise executive and trust board support and ongoing commitment for the Productive Operating Theatre programme.  It will help trusts to consider and put in place key elements to ensure organisations and patients gain maximum benefit from the programme.

Programme Leader's Guide - This guide will help organisations to put together a practical, open and realistic plan for starting, spreading and sustaining the Productive Operating Theatre.  It is not a 'how to' guide for programme management, rather its a simple and quick reference of key points to combine with experience, knowledge and existing programme leadership. 

Knowing How We Are Doing - This module is intended to help teams build processes for identifying, using and evaluating measures for theatres at each appropriate level in the organisation.  It is a key foundation module within the Productive framework and helps to monitor improvements accurately, and share them with the theatre team. 

Well Organised Theatre - The well organised theatre is an approach to simplify the workplace and reduce waste by having everything in the right place at the right time and ready to go.  This module describes how to create a well organised theatre using the 5S approach.  5S is a methodology involving the structured implementation of five key steps to help create an idea workshop through organising, cleaning and removing the seven wastes.  This will reduce the time and effort required by staff to perform tasks in the area.

Operational Status At A Glance - Operational status at a glance is a visual management tool which allows those responsible for coordinating resources and staff in the theatre suite to understand operational status, at any point throughout the day, in real-time.  This helps to manage any quality, safety or operational issues as they arise.  This module will help teams develop the systems to coordinate and actively manage your whole suite of theatres. 

Team Working - The team working module focuses on enhancing multidisciplinary team working within operating theatres.  By developing and implementing communication tools, such as briefing, debriefing, WHO checklist and SBAR, teams can improve patient safety by reducing mistakes and errors and create a better working atmosphere for the theatre team.  This can lead to an improvement in the safety culture in theatres and reduce glitches, errors and avoidable harm to patients.  Improving team working also has a positive effect on staff morale and efficiency.

Scheduling - The scheduling module provides a practical approach to understanding theatre scheduling systems and processes, identifying where and how teams can make improvements to deliver a reliable, achievable list in a timely manner.  This enable steams to make the most effective use of theatre capacity, knowledge and experience, and the resources available.  Effective scheduling of operating sessions is essential to improve services to patients, provide organised achievable lists for staff, and ensure optimum use of operating theatre capacity.  

Session Start-Up - Session start-up plays a vital role in ensuring that theatres run efficiently.  A high performing operating team is consistently well prepared and starts on time with a full multidisciplinary pre-session brief.  This sets the standard and the momentum for safety and efficiency for the whole day.  A well scheduled list that starts on time should also finish on time.  All these factors will contribute to creating a high quality patient experience as well as increasing staff satisfaction.

Patient Preparation - The patient preparation module provides a practical approach that will help teams to identify all the key elements required to ensure every patient arrives in theatre prepared for surgery. Getting patient preparation right will also support session start-up and patient turnaround.  Although the theatre team depend on patient preparation to ensure their day runs smoothly, much of the preparation process takes place outside the theatre environment, and with teams who work outside theatres, this module helps to bring all key stakeholders together to improve the process for the benefit of the patients.

Patient Turnaround - The patient turnaround module provides a valuable opportunity for staff to work closely with those involved with patient preparation to determine how best to get the next patient to arrive in the theatre at the optimum time.  It will support teams in allocating tasks within the team to transfer the previous patient to recovery whilst preparing the anaesthetic equipment and operating theatre for the next procedure.  The patient turnaround module provides a structured approach to help teams review their current turnaround procedures.  It will help teams to identify where you can introduce standard procedures for the team to turn the theatre around safely and efficiently.

Handover - Handover occurs frequently at several stages in the patients pathway.  This module provides a practical and structured way to help improve the process of managing handovers, ensuring that relevant information, documentation and plans for further management (short and long term) are effectively and safely transferred from one clinician to another.

Consumables & Equipment - Consumables and equipment are two of the main resources that are managed by theatres.  The management of both of these resources involved complex systems.  Problems within these systems can have a significant impact on the daily operational running and the financial performance of theatres.

Recovery - The recovery module will help to analyse and improve how patients are managed immediately after surgery.  It focuses on the information flows, processes and activities required to care for patients in recovery.  This module covers the patients journey form the time they leave the theatre post-operatively, through recovery, until they are either discharged home or to an inpatient surgical ward.