Enhancing Breast Cancer Surgical Throughput

Transcript

2. Association of Breast Surgery Conference 2026 | Glasgow Enhancing Breast Cancer Surgical Throughput: A Staffing-Driven Quality Improvement Initiative Miss Anamaria Schipor Breast Surgery Specialty Doctor Under the supervision of: Miss Hannah Winter Consultant Oncoplastic Breast Surgeon patient at heart • everyday excellence • creative collaboration
3. Plan: Identify the Problem 36.1% 3.3 28 min 60% compliance cases per list median turnaround of lists overran Cancer surgery waiting time targets failing Poor theatre productivity Long delays between every patient Frequent overruns causing staff pressure Against an 85% national target — a regulatory crisis Limited patient throughput on every operating list Wasted theatre time between each case Unsustainable for teams and inefficient for patients patient at heart • everyday excellence • creative collaboration
4. Plan: Aim and Change Idea Work smarter, not harder Aim System redesign — not asking staff to work faster • Improve theatre flow and increase cases per list • Restore compliance with cancer surgery waiting time targets Increase staffing on a dedicated breast surgery list Change Idea Three additional roles to remove the bottlenecks • Additional anaesthetist • Additional ODP • Additional scrub nurse Cancer Alliance funding Enabler A funded pilot to test the theory before wider adoption patient at heart • everyday excellence • creative collaboration
5. DO: Implementation and Data Collection Go live: 30th September 2025 Implementati on 14 enhanced theatre lists run over the pilot period Prospective data collected and compared against 10 baseline lists (June–September 2025) Data Collection • Cancer performance metrics (monthly compliance %) • Number of cases per list • Turnaround times between patients • Structured colleague feedback after each list • Safety incidents monitored throughout patient at heart • everyday excellence • creative collaboration
6. Study: Cancer Performance Metrics 3rd theatre added ↓ patient at heart • everyday excellence • creative collaboration Enhanced lists launched ↓
7. Study: Turnaround Time BEFORE AFTER 28 min 8 min median turnaround time → Only 4% of turnarounds < 10 min median turnaround time 63% of turnarounds < 10 min p < 0.001 — statistically significant patient at heart • everyday excellence • creative collaboration
8. Study: Number of Cases per List Average cases per list 3.3 → baseline Lists achieving 5 cases 0% + 27% increase → not once achieved Lists that over-ran 60% 4.2 31% of all lists → of all lists The 3 lists with 3 patients finished early — 14:30 / 14:54 / 15:20 patient at heart • everyday excellence • creative collaboration 14% minimal overrun only
9. Study: Colleague Feedback Theatre Efficiency Feedback Form | 11 lists | 84 responses Theatre Atmosphere Today How was your workload? Very Positive 52.2% Positive 37.7% Neutral 2.9% Negative / Very Negative patient at heart • everyday excellence • creative collaboration 0%
10. Act: Decision and Spread ADOPT Decision The model is effective, safe, sustainable and acceptable to the team Model now being trialled by General Surgery at PAH Spread Demonstrating replicability across surgical specialties within the same Trust patient at heart • everyday excellence • creative collaboration
11. Take Home Messages 01 02 Productivity improves when systems improve Strategic staffing resolves theatre bottlenecks Not when staff work harder Without causing staff burnout or safety compromise 03 04 Efficiency drives cancer patient outcomes The model is replicable Turnaround time directly impacts waiting time compliance Already adopted across surgical specialties at PAH patient at heart • everyday excellence • creative collaboration
12. Thank You Questions welcome “ Every system is perfectly designed to get the results it gets. — W. Edwards Deming Our turnaround time inspiration 🏎 patient at heart • everyday excellence • creative collaboration