Background In the current financial climate, approaches to improving clinical practice must be innovative and cost-effective. Delays in trauma theatre start and turnover times have significant productivity and economic costs, estimated to be -£20–24.77/minute.

Aims To improve the average trauma theatre start time and turnover time by 33% each at Medway Maritime Hospital.

Methods We identified several bottlenecks impeding theatre efficiency. Incomplete pre-operative workup of the ‘golden patient’(the first trauma day case) significantly delayed theatre start times. Further delays pertained to staffing levels, bed availability and lack of a cyclical flow-through system. We consulted key clinical and managerial staff to develop three interventions based on feasibility, impact and cost, and assessed their efficacy: (1) a Golden Patient Proforma (GPP), (2) utilising the exit corridor, and simultaneously (3) prioritising recovery room beds for trauma inpatients. Statistical analysis was performed using the unpaired t-test.

Results The GPP improved theatre start times by 12:56 min (29.7%), and combined exit corridor use with recovery room prioritisation reduced theatre turnover times by 16:02 min (63.5%, p<0.005). With an average of 3 operations being performed daily, these interventions saved 45 minutes/day, corresponding to estimated annual savings of -£3 28 500.

Discussion Through three simple interventions, we significantly enhanced trauma theatre flow and improved theatre productivity, reducing patient waiting times and mitigating damaging financial losses. Implementing these interventions in a busy trauma theatre required the cooperation of all team members, and an appreciation of balancing measures to avoid burdening a complex and multifaceted system, underscoring the importance of effective inter-professional communication. Early involvement of all stakeholders is vital in securing compliance with proposed interventions.