Does the process of implementing service line management affect the theatre utilisation?

Marriott, Paul James (2014). Does the process of implementing service line management affect the theatre utilisation? University of Birmingham. M.D.

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Introduction: The English National Health Service (NHS) is rationalising services to ensure healthcare remains sustainable. Implementation of Service Line Management (SLM) is recommended, as it is believed to empower clinical leaders to improve resource use and make cost efficiency savings in areas such as operating theatres (OT). The aim of this study was to examine if, how and why, SLM affects theatre utilisation.
Methods: A mixed methods multiphase process evaluation design was used. Three years of theatre utilisation quantitative data, 35 semi-structured interviews and focussed observations were undertaken. The study focussed on elective colorectal surgery in two English NHS hospitals.
Results: OTs were found to be inefficient. SLM implementation was minimal. Theatre data was not valued or used to affect performance and interviewees felt, in part, due to organisational structures, unable to control processes. Consequently, minimal impact on the cost effectiveness and efficiency of OTs was identified.
Conclusion: To improve the cost effectiveness of OT, NHS hospitals need to invest in data systems and develop organisational structures that devolve control to clinical leaders and promote staff collaboration. Without these elements, SLM cannot be implemented and its potential impact will not be established.

Type of Work: Thesis (Higher Doctorates > M.D.)
Award Type: Higher Doctorates > M.D.
College/Faculty: Colleges (2008 onwards) > College of Medical & Dental Sciences
School or Department: School of Health and Population Sciences
Funders: None/not applicable
Subjects: H Social Sciences > HD Industries. Land use. Labor > HD28 Management. Industrial Management
R Medicine > RA Public aspects of medicine


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