Recommendations proposed by the National Evaluation and Productivity Commission are considered by the Ministry of Health

To increase the number of daily surgeries through more efficient utilization of operating rooms, the National Evaluation and Productivity Commission (NEPC) conducted a study in 2020 titled “Efficiency in Operating Rooms and Patient Prioritization for Elective Surgery,” which included a set of 26 recommendations provided to the Chilean government.

Recently, the Ministry of Health has begun implementing a training plan for higher-level nursing technicians (TENS) and non-medical staff, aligning with the diagnosis and the measures proposed by the NEPC.

Thursday, April 20, 2023.
Nearly 500 staff members from public hospitals across the country have started a course in anesthesia for higher-level nursing technicians (TENS) and non-medical professionals. The action, which aims to train a total of 5,000 workers, is part of the Regional Resolution Centers (CRR) strategy aimed at addressing surgical waiting list times in the country.

This initiative, led by the CRR team at the Ministry of Health and the Training Department of the Undersecretariat of Healthcare Networks, is based on the diagnosis provided by the NEPC.

The NEPC identified, among its findings, that an average operating room in Chile is utilized only 53% of the available time (4.8 out of 9 hours per day). Factors contributing to this underutilization include that the first surgery in Chile starts (on average) 40 minutes late, and the last surgery finishes nearly 2 hours earlier than scheduled. In contrast, delays and early finishes in the United Kingdom are minimal (averaging between 6-12 minutes).
Consequently, Chile performs 3.3 surgeries per day per operating room compared to 5.1 daily surgeries in the United Kingdom.

The document also highlights another concerning issue, which is that 12% of scheduled surgeries are canceled (ranging from 4% to 20%), while the international standard is 5%. Additionally, one-third of these cancellations are due to patient-related causes, and 17% to surgical delays.

Furthermore, a factor contributing to surgery cancellations is absenteeism. 56% of nursing technicians (TENS) request at least one sick leave per year, which translates to an average of 27 sick leave days for TENS working in operating rooms, with 20% absent each month.

In this context, the NEPC recommended the establishment of an additional staffing system for the support team in the operating room (nursing and higher-level nursing technicians -TENS) to address issues related to reducing absenteeism levels, delays and promoting the development of certified skills linked to the participation of TENS in the operating room and their multi-functionality.

According to the NEPC study, there are currently no specialties associated with operating rooms in the training programs except for sterile supply management. However, several hospitals mentioned during the survey that they still have to provide additional training to TENS in this area.

According to the Ministry of Health, this measure will expand the surgical waiting list’s capacity by closing the gap in specialized personnel required for operating rooms, a step forward in improving operating room productivity, according to the analysis conducted by the NEPC.