1. Computerised Theatre Register
Minimum Dataset Project in
Acute Hospitals in Cork & Kerry
Judy Cronin
Dr. Orla Healy
Heather Hegarty
Dept. of Public
Health, HSE
South
Presentation to HISI Thur Nov 17th 2011

2. Background
 A review of theatre activity in 2008 in all HSE hospitals in
Cork and Kerry was conducted under the Reconfiguration of
Health Services.
 Theatre logbooks or registers varied from place to place
 All were manually entered, paper based systems
 Computer systems existed, they did so in parallel with paper
based systems
 Similar but not standardised data
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3. Key Data Management Recommendation:
“A standardised computerised theatre logbook
system developed in all hospitals.”
HSE Performance Report February 2009 (2nd April 2009); page 32
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4. Extracting data for THEATRE review, audit
or service planning is extremely difficult
o time consuming
o labour intensive
o inefficient
o expensive
o a major logistical challenge
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o security concerns

5. Project Purpose
o Requirement for high quality information.
o The HSE needs to be able to source, analyse and
interpret routine data to inform key decisions.
o Standardised and computerised theatre registers will
facilitate quality assurance, performance monitoring, audit,
look-back and research.
o We can’t keep manually counting and re-counting log
book entries for patient recalls/reviews
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6. The advantages of an electronic logbook:
• More efficient data access
• Higher data quality
• Increased ability to conduct quality improvement
and clinical research activities.
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7. Scope
Establishment of Computerised Minimum
Dataset (CMD) Group
The scope of this project was as follows:
1) Minimum Dataset (MDS):
o Agree MDS
o Develop data dictionary
2) Computerisation:
o Identify what computer systems are currently in use in
hospitals and theatres relevant to computerising theatre
registers.
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8. iSoft Operating Theatre Module
MDS Collation
Systems in use Meetings with Meetings with Meetings with
across all Hospitals
Nationally Theatre Managers CUH IT TPOT Group
Cork & Kerry
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9. MDS Theatres – Current picture
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10. Systems in use Nationally
Table 1 Results of Operating Theatre Telephone Questionnaire
34 (61.8%)
No Computerised Operating
Theatre System
Dual Paper-based AND 6 (11%)
Computerised Operating
Theatre System
Fully electronic Operating 8 (14.5%) (2
Theatre System Hospitals very
unhappy with
similar system)
Electronic Orthopaedic 5 (9%)
Operating System only
No Reply 2 (3.6%)
Total 55 (100%)
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11. Fact Finding Mission – Meetings with Theatre Managers
• HSE WEST IPMS Operating Theatre presentation
• Roll-out of IPMS Theatre module in Letterkenny, Sligo & UCHG
• Senior Management and IT support critical.
• Used ICD-10 HIPE Codes
• Recommends a succession plan post implementation (add a procedure)
• On-site visit to Tallaght
• High level Governance group & excellent IT support (dedicated IPMS IT Project Co-
Ordinator)
• Product Initiation Document and Cost Benefit Analysis Report. Extra data points, PC’s – Thin
Client and washable keyboards.
• Used ICD-10 HIPE Codes – manually inputted.
• Procedure codes associated with each Consultant – system monitors time & adjusts time.
• Used widely for audit and has vastly improved efficiency.
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12. CUH IT – IPMS Operating Theatre Project
IPMS Theatre IT Project driver in CUH
• Theatre 3 Neurosurgery – fully implemented 24/7
• CUMH Gynae/Obstetrics – fully implemented 24/7
• Theatre 1 and 1A Cardiothoracic – one year, then stopped.
• Currently used for theatre bookings or elective list in 1, 1A, 5, 6 & 7, 8.
OBSTACLES
• Key Theatre staff drivers (willing to run with this)
Governance (at Mgt. level to push project forward)
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13. Legal status of Log Books
“there is no legal reason why we cannot move
to a fully computerised Theatre Log Book”
In-house HSE Barrister
“Theatre register should be kept in every
theatre to record essential details of all
surgical procedures. It can be either
paper, book format or electronic.”
Standards & Recommendations for Safe Peri-Operative Practice (Pg 28Afpp 2007) 1.12.2.
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14. IPMS Screen Shots – Theatre Overview CUH
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15. CUH IT – IPMS- In-Theatre Details Tab
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16. Data Dictionary
IPMS
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17. TPOT Project – The Productive Operating
Theatre group
TPOT is interested in …
data that could or would be useful when
looking at making improvements in the
future.
the same core data collected via IPMS is at the
centre of both projects.
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18. New South Wales Health Department,
Operating Theatre Management Project Report
Only 29 facilities were using the same definitions.
The report states that
“establishing common data definitions was
essential to ensure comparability of activity
data..
A revised MDS be mandated across NSW Health
System”
New South Wales Health Department, NSW Health Operating Theatre Management 18
Project Report, NSW, 2002

19. Where we are at now……
CMD TPOT
IPMS
Combine our efforts.
CUH
• Local Theatre Manager drivers identified
• Orthopaedics is now the Productive Theatre “Showcase Theatre”
• Implementing IPMS Operating Theatre module Theatre by
Theatre
TGH
• Building their Theatre IT systems/scheduling system in Kerry
from paper basis.
• Eager and ready to move to IPMS
Nov 2011 Kerry General is scheduled to go-live
MUH & SIVUH
• Just implemented IPMS across the Hospitals (with the intention
of making the Operating Theatre Module available)
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20. It is our recommendation that ..
• All Acute Hospitals computerise the theatre register
• Where available IPMS be used as the system to achieve automation
• Where other IT systems are employed, the same core MDS is collected
• TPOT review the minimum dataset and data dictionary agreed by
this group with a view to national adoption.
• TPOT review the extra key data items recommended by this group
and consider what other items will be required for performance
monitoring in the future
• TPOT liaise with the HSE National iSoft Liaison link to negotiate a
consistent coordinated approach to IT development in Theatres and
minimise the costs involved
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21. CMD Group Members
Dr. Orla Healy – Project Lead Reconfiguration
Judy Cronin Health Informatics Manager DPH
Heather Hegarty Senior Research Officer DPH
Catherine Buttimer Theatre Manager MUH
Donnacha Jordan Theatre Manager MUH
Eilish Daly CNM2 for Theatres SIVUH
Fionuala O’Gorman Perioperative Facilitator CUH
Andrea Kennedy CNM1 for Theatres CUH
Caitriona Hayes CNM3 for Theatres KGH
Mary O’Regan-Barsum CNM2 for Theatres BGH
Margaret Angland, A/Clinical Nurse Manager 2 SMOH Ortho
Lorraine O’Connor Clinical Nurse Manager 2 for CUMH Theatres
Geraldine Keohane Director Of Midwifery CUMH
Sheila Spillane Nursing IT CUH 21
Mary-Rose Dennehy IT CUH