Royal College of Surgeons in Ireland Coláiste Ríoga na Máinleá in Éirinn

Theatre Quality Improvement Programme (TQIP) 2017

While much success was achieved one of the challenges and lesson learned from the TPOT programme experience was that sites found it difficult to embark on the improvement journey without Improvement facilitation. In 2017 the HSE, NCPS and NCPA collaborated with RCSI's Quality and Process Improvement Centre (QPIC) to deliver a Quality and Process Improvement programme where onsite facilitation and coaching was central component.

The programme is currently piloting in 2 sites and further sites will be invited to participate in 2018.

The TQIP approach includes on-site QI training facilitation and certification, MDT team involvement, appointment of a dedicated project lead, perioperative governance and standardised KPIs.

TQIP focus areas in the perioperative journey

Pre-Operative Intra-Operative Post-Operative

Demand and capacity planning

  • Scheduling
  • Protected beds
  • Elective day and inpatient pathway

Theatre utilisation and list planning

  • Patient transfer
  • Session on-time start
  • Elective day and inpatient pathway
  • Session on-time start
  • Anaesthetic start time
  • Surgery start time
  • Turnaround time
  • Intraoperative interval
  • Session finish time
  • List overruns
  • Inventory management
  • 5S

Post-operative pathway

  • Handover
  • Recovery: Delayed admissions
  • Recovery: Delayed discharges
  • Post-operative bed management


  • Pre-admission assessment
  • Discharge planning

Surgical safety checklist

  • Briefing/de-briefing

Enhanced recovery

Enhanced recovery

  • Patient preparation

Visual management


  • Discharge planning
  • Visual management
  • Visual management