Emergency trauma theatre utilisation – the St George’s Hospital, London experience

Background The Royal College of Surgeons of England encouraged the creation of singly dedicated 24-hour emergency theatres in 1997; emergency operating was previously largely determined by theatre availability rather than clinical need. Shortly after this St George’s Hospital, London designated one of its three trauma theatres as an ‘Acute Emergency Theatre’ (AET) and implemented a policy to maintain access to the AET within one hour’s notification for all acute trauma emergencies. On review it was felt that the system underutilised scarce theatre space and limited the repertoire of surgeries that could be performed. A more efficient use of theatre space was therefore sought. The AET was changed from a fixed physical entity to a nominal entity; where by the AET could be any of the three major trauma theatres, as long as one of them was available within one hour.