Utilization of the operating theaters in governmental hospitals in Gaza Governorates

Tayser M. ELSultan
تيسير محمود محمد سلطان
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Al-Quds University
Extensive operating room utilization is a goal of most 0perating rooms directors and hospital administrators. Assessing the procedures and processes performed in operation rooms is the first step of evaluating the quality of care and efficiency of utilization of these rooms. This study aims to assess the current utilization of operating theaters and the time factor involved in these theaters in governmental hospitals in Gaza Governorates in order to improve the quality of current operation rooms and facilities. A triangulated cross sectional quantitative, qualitative study was conducted in order to assess the procedures and processes implemented in these theaters. The instruments used in this study were self-constructed questionnaire, reviewing of 100 medical records for availability and completeness of these records and in depth interview for 9 mangers (doctors and nurses). All the medical staff (220) who were working in the operating theaters in three governmental hospitals were included in the study, out of them, 198 responded and completed self-constructed questionnaires, with a response rate of 90%. The researcher collected the data by himself. General measures of reliability and validity were used, Cronbach s alpha reliability test was 0.8954. The study findings show that, most procedures which are done by doctors (surgeons and anesthesiologists) prior to surgery are done properly, but these procedures are not always done properly by the surgical department nursing staff. The study findings also show that most of needed records are available and completed in the patient s file but there is a real problem in completeness of some file records especially records related to the anesthesia and recovery sheets (80% are not completed), and also history and physical examination sheets(74% are not completed). The study results also show that there is absence of policy, standards and protocol which are essential for regulating the performance of the procedures, in addition to absence of job description which lead to role ambiguity. Moreover the number of daily working hours of the routine operating list are not appropriated with the number of operations, which it was considered the most important reason of the postponement of some cases from such list and then increasing the number of patients on the waiting list. The researcher concluded that most of procedures are performed in a traditional way and not regulated by protocols according to standards, and the policy is an old one and not revised or reformed since a long time passed on scientific base. The researcher recommended that the policy should be reformed, and standards and protocols should be established in order to improve the quality of health care services in operating theaters, the researcher also recommend for a further study to investigate barriers and motives for implementing procedures according to standards from healthcare providers perspectives