Quantification of emergency operating theatre process performance: a systematic review of clinical studies
Authors' conclusion
There is a tendency within clinical studies to focus on effectiveness rather than efficiency, potentially reflecting clinicians' focus on patient outcome. Systematic biases that reduce evidence quality are common, creating uncertainty in the validity and generalisability of results.
Study context
- Population
- Clinical studies quantifying emergency operating theatre process performance32 clinical studies
- Outcome
- Metrics used to quantify emergency operating theatre performance and methodological quality of the literature
Methodological detailsROBINS-I and GRADE quality assessment, PubMed, ISI Web of Knowledge and Embase searched from inception to December 2024
- ROBINS-I and GRADE quality assessment
- PubMed, ISI Web of Knowledge and Embase searched from inception to December 2024
Pooled result
As reported in the abstract
Performance metrics and study quality
- Performance metrics identified (6 efficiency; 10 effectiveness; 3 productivity)
- 19
- Performance metrics per study, median (range)
- 4 (1-7)
- Out-of-hours operating reported
- 19 studies; 59%
- Delay reported
- 17 studies; 53%
- Utilisation reported
- 13 studies; 41%
- Low quality studies
- 11 (34%)
- Very low quality studies
- 21 (66%)
- Insufficient metrics
- 26 (81%)
- Non-generalisable metrics
- 30 (94%)
- Trade-off between metrics not quantified
- 29 (91%)
- Insufficient scope of investigation
- 16 (50%)
Further pooled results
Interventions evaluated
- Reallocating theatre time
- eight studies; 25%
- Increasing emergency theatre capacity
- eight studies; 25%
- Instituting acute care surgery services
- six studies; 19%
Original publication
Quantification of emergency operating theatre process performance: a systematic review of clinical studies. Br J Anaesth. Published 4 February 2026. doi:10.
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