Operation Theatre (OT) Management

From the surgeon's booking to the recovery-room discharge, on one linked record. EloHIMS carries the pre-op form, cost estimate and consent from the booking to the theatre case, will not let anaesthesia start on a planned case without fitness cleared and consent recorded, and records the anaesthesia chart and the Aldrete recovery score before the patient leaves.

A governed theatre, from booking to recovery

Patients reach theatre prepared, cleared and priced

Surgery starts at the consult: "Book OT" opens a booking with the surgeon and diagnosis already filled. The booking sits on a structured surgical waiting list, and the desk can hold the post-op bed against it.

The pre-op form in the booking records the airway (Mallampati, mouth opening, neck, dentition, difficult airway expected), comorbidities, ASA, a standard panel of investigations with their results, the blood group and units arranged — or blood not required — and the fasting time. The readiness ticks follow the form: work-up is done when every test has a result, NPO when fasting is recorded, cross-match when blood is arranged or not needed.

The cost estimate is worked out from the booking's surgical package: the package fee, the cover from the patient's welfare band, and what the patient pays — printed as a "Cost Estimate" slip for the family.

Nothing starts without fitness cleared and consent signed

The OT case is created from its booking and the two are linked both ways. The case reads the booking's readiness — fitness, consent, work-up — through the link and shows it on screen. The booking follows the case: completed marks it done, and a cancelled case sends the patient back to the waiting list.

At the WHO sign-in, induction is refused while the booking's fitness is not cleared or consent is missing. Consent is a record, not a tick: it is set when a consent is signed and cleared when it is withdrawn, and a ticked box posted by hand is ignored. Emergency bookings are exempt from this check — an emergency cannot wait for a fitness clinic.

The anaesthesia chart, on the case, signed and locked

The Anaesthesia tab on the OT case records the technique, ASA, induction and end times with the duration, and the airway — device, size, Cormack–Lehane grade, attempts and whether it was difficult. Grids hold the vitals (with a time-ordered HR, systolic BP and SpO₂ trend), drugs from a common-drug list with route, fluids, blood loss and urine output, events and notes.

The anaesthetist can start a draft at pre-op. Sign & lock needs the induction time, at least one set of vitals and, for a general anaesthetic, the airway device. A theatre rule can make the signed record a condition of completing the case; local-anaesthesia cases are exempt.

Leaving recovery takes a modified Aldrete score of 9 or more

The Recovery tab on the OT case holds a modified Aldrete grid — five items scored 0–2 — and a pain score from 0 to 10. The system totals each set and uses the latest by time.

The destination is chosen on discharge from recovery. Ward — the patient's own bed, or a new bed, which moves the admission with them — and home as a day case both need the latest score to be 9 or more. ICU is the only destination allowed below 9. A theatre rule can make the recovery discharge a required step before the case is completed.

Post-op orders on the ward chart, and batch days for high-volume lists

When a case is completed, each post-op instruction line and each drain becomes a nursing order on the patient's admission, traceable to the case. The op note, drains and implants appear on the inpatient ward chart's Operations tab and the ICU chart, and the op note and implants go into the discharge summary.

For lists of the same operation, cases of one procedure in one theatre on one day can be run as a batch; other procedures, theatres or dates are refused, and a batch of one dissolves. The Batch Surgery Days page shows the theatre order, the planned lens power for eye cases and progress, and prints the day's list. For eye surgery — biometry before listing and D1/W1/M1 post-op reviews — see ophthalmology. Caesarean deliveries tie to their theatre case in obstetrics & gynaecology.

The OT is where charges get missed and records go missing

Theatres are known for un-invoiced cases and scattered operative notes. EloHIMS runs the OT as a governed clinical and financial workflow: the structured case record captures surgeon, anaesthetist, procedure and findings, the OT register is compiled as you work, and every charge goes through the same billing and general-ledger engine as the rest of the hospital — including walk-in and emergency cases.

The result is a theatre that is planned in advance, documented while it happens, and reconciled to the patient's account before they leave recovery.

What do OT charges mean?

OT charges are what a hospital bills for an operation in its operation theatre — typically the theatre itself, the surgeon and anaesthetist, and the drugs and consumables used on the case. In EloHIMS the cost estimate is set when the operation is booked, and the case's charges post to the patient's bill through the same billing engine as the rest of the hospital.