A new independent study into which factors might contribute to the success of high-performing elective surgical hubs has been published in a leading journal.
Researchers from The Healthcare Improvement Studies Institute (THIS Institute) at the University of Cambridge carried out the work, which is published in the latest Bulletin of the Royal College of Surgeons.
The study concludes that the best-performing surgical hubs treat high performance as something to keep working on, collecting data and feedback from staff to enable them to adapt and respond as situations change. It also found that high-performing hubs follow the guidelines set out by bodies such as GIRFT, putting good practice into action and drawing on evidence about how to improve productivity.
Part of GIRFT’s remit is to support systems with the creation of elective surgical hubs, separated from hospital emergency services, to carry out high volume low complexity procedures at scale within defined standards.
Surgical hubs are part of plans nationally to increase capacity for elective care. They enable shorter waiting times, higher rates of same-day discharge and reduced need for follow up treatment.
GIRFT has developed a hub accreditation scheme, in collaboration with the Royal College of Surgeons and supported by the Royal College of Anaesthetists, to assess hubs against a framework of clinical and operational standards. 83 of the current 125 hubs in England have so far been successfully accredited.
The THIS Institute study involved qualitative interviews with staff members from five high-performing surgical hubs, with the aim of identifying the features of hubs which contribute to strong performance in optimising care delivery, with a view to offering practical insights for those leading new and existing surgical hubs.
All hubs in the sample enacted the standards set out by GIRFT and drew on our range of surgical hubs guidance.
The study outlines its findings in three categories:
- Standardisation and rigorous delivery: for example, a strong commitment to the surgical hub model, the ring-fencing of elective activity, optimising theatre utilisation, closely monitoring performance data and high-quality leadership.
- Insight, intuition and adaptation: including sustained effort and ongoing responsiveness as circumstances change, involving colleagues from across the multidisciplinary team in learning from data, and valuing the views of staff and patients as a source of ideas for improvement.
- Making the best of circumstance: some interviewees described circumstances such as host organisations being more receptive to requests for funding, more favourable estate infrastructure and good layout of operating theatres. However, interviewees also described how organisations worked flexibly to overcome problems, framing them as surmountable challenges.
Insights from the THIS Institute study will be taken into consideration, alongside the existing evidence base and findings from the GIRFT Hub Optimisation Week, to guide hubs in their efforts to improve efficiency and productivity.
