The hospital team is clearing the OR backlog by treating the OR like an F1 pit stop and performing quick turnaround surgeries

Dr Imran Ahmad was pedaling his spin bike on a Saturday morning last year when he had a big idea – one that could help save the NHS.

As a consultant anesthetist at Guy’s and St Thomas’ Hospital in London, he suddenly envisioned a team of surgeons and OR staff to help manage the backlog of patients awaiting surgery.

It will operate like a Formula 1 pitstop team, carrying out carefully planned, high-speed operations with quick changeovers.

And so the Guy’s and St Thomas High Intensity Theater (HIT) team was born – and proved to be every bit as turbocharged as its racing inspiration.

On one amazing day last month, the team completed eight prostate cancer operations by 5pm – under the standard system they would have performed just three and would have been done by 7.30pm. This is the most spectacular result in HIT’s 18 missions so far (with various specialties including joint replacement).

“Our efficiency was quite phenomenal,” says Dr. Ahmed proud. The trick is in the planning: “Like on the track, everyone has a role, everyone knows exactly what to do, and they do it very well.”

It is encouraging to see amid the gloom surrounding the state of the NHS and fears that it will collapse under pressure.

Shocking new figures show more than seven million people are on a waiting list for NHS treatment; ambulance response times to major incidents are more than double what they should be; and a record 32,776 people waited more than 12 hours in emergency rooms in September. Just a few of the many statistics that illustrate a healthcare service on the brink.

Amanda Pritchard, chief executive of NHS England, recently said the health service was struggling to cope with a £7bn shortfall in its budgets. But it’s not just about money; Angry medics have been complaining about the NHS’s suffocating bureaucracy for years.

Dr. Ahmad was able to take over the management as he holds a key position as Deputy Clinical Director of the Trust’s operating theatres.

The Formula 1 pit stop in its analogy is the operating room.

“I wanted surgeons to spend 90 percent of their time in the operating room,” he says. Currently, most only operate for 30-40 percent of their day, as time is spent visiting wards and waiting while patients are sedated or recovering from surgery.

This meant carefully streamlining all the processes around them so they could get on with their work. Ironically, Covid was the catalyst for this innovative change. DR Ahmad found himself on the front lines of the Covid pandemic as critically ill patients struggling to breathe threatened to overwhelm intensive care units. He developed an emergency response and reorganized his staff into rapid intubation, tracheostomy and critical care teams.

It will operate like a Formula 1 pitstop team, carrying out carefully planned, high-speed operations with quick changeovers. A stock photo is used above [File photo]

The waiting lists for other treatments were already growing when he experienced his aha moment on the ergometer: “I thought: why don’t we do the same to eliminate the huge surgical backlog?”

The HIT teams he envisioned would perform surgeries at a rate above the norm, and that meant working on Saturdays, a day when there weren’t typically pre-booked surgeries.

Dr Ahmad believed that if they opted for relatively short daily surgeries – preferably less than an hour – they could create a kind of medical assembly line. An additional benefit would be that removing simple operations from the regular lists would free up space for more complex operations during the week.

He started by looking closely at the “patient journey” and figuring out how to streamline it—for example, by taking a group that all needed similar hernia operations and figuring out how to be a “one-stop shop,” prepared for the operation. ‘. Blood tests, clearance and pre-operative health checks can all be carried out at the same time.

If he doubled the size of their usual team, they could do four times as many operations.

Using two theaters simultaneously allows surgeons to “jump back and forth” between them. More nurses cleaning and preparing the operating room for the next patient reduced the time it takes to complete their duties from 20 minutes to five.

The incentive for employees is an additional daily wage at a higher weekend rate. “And everyone gets paid by 5 p.m., no matter how early we finish,” says Dr. ahmad “It’s important because it reverses the norm in the NHS, which is that you get extra work when you finish and don’t get paid for it.

“I also buy lunches – pizzas for everyone – and because we have extra staff, everyone gets a break. The most important thing is that there is a sense of achievement. It’s fun because it’s a stretch.” To date, HIT teams have worked 18 Saturdays in eight specialties, including knee and hip replacement and breast cancer surgery.

They performed 344 operations and hope to bring that number to 400 by the end of the year.

News of the team’s success is doing the rounds: The Department of Health and NHS England have dr. Ahmad was asked to give a presentation, and hospitals abroad approached him to copy the idea.

“Around 80 per cent of the seven million on the NHS waiting list are likely to meet the HIT criteria,” says Dr. ahmad “There are at least 1,000 hospitals in the UK, so if we can scale that up, if even 50 or so can do it once or twice a month, imagine the dent we can make in that waiting list. “

Not all hospitals are equipped to put together a HIT team – they need a backup operating room for emergencies, so have at least three.

Shocking new figures show more than seven million people are on a waiting list for NHS treatment; ambulance response times to major incidents are more than double what they should be; and a record 32,776 people waited more than 12 hours in emergency rooms in September

The prostate cancer surgery performed last month is the most complex ever attempted. Four surgeons took turns performing the operations, which last 90 minutes and involve robots for precision.

Ben Challacombe, a consultant surgical urologist, performed the operations with the shortest turnaround time between patients – just over 30 seconds. “I put it on Twitter and it got 40,000 views. People from all over the world responded. I’ve never seen anything like it.’

HIT was a challenging day, “but there was a feeling of energy and togetherness,” he says. “There is a special smile in the hospital among the people who were part of the teams, because you know you are doing something special.”

Patient care was his top priority.

“These men had cancer, so they needed support. The specialist nurses who took care of this were wonderful, as were the administration team who set the appointments carefully to make it work.”

Mick Jennings (59) was one of the patients who underwent surgery that day. The diagnosis was made in early September after a blood test showed he had elevated levels of PSA – a marker of prostate cancer. “It was a bit of a shock … of course you think about your family,” he said.

All eight men operated on that day were together in the preoperative operation. “We all met again on the day of the operation and at a follow-up, so we kind of became friends and some of us are still in touch via WhatsApp,” Mick added. “To send words of encouragement as we recover and to have these kindred spirits has been a good thing for all of us.”

A month later, Mick, an anesthetist at nearby Lewisham Hospital, is recovering well and considering returning to work.

He agrees that other hospitals would do well to adopt the HIT initiative.

“It shows that listening to the people who work in healthcare and allowing them to follow their ideas can work very effectively,” he says. “If you ask a hospital’s clinical staff what’s wrong with the service, they’ll give you an honest answer – and they might have a good idea about how to fix the problem.”

Best sleeping position for you

This week: Sleep on your left side if you have heartburn

Heartburn, also known as acid regurgitation, is caused by stomach acid backing up into the esophagus. A Dutch study published earlier this year in the journal Brief Communication: Esophagus found that while reflux occurs in all sleeping positions, acid stays in the esophagus for an average of 90 seconds in people who sleep on their right side; on the back it lasted 76 seconds, but when sleeping on the left side it disappeared in an average of 35 seconds. It reduces the risk of symptoms that disrupt sleep and lowers the risk of damage to the esophagus, which can increase the risk of esophageal cancer. The reason for this is still being investigated.