Manchester Veterinary Specialists project recognised for improving efficiency and patient safety across orthopaedic surgical care

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Highly commended RCVS Knowledge Awards project delivers sustained reductions in anaesthetic waiting times and supports safer patient journeys

A quality improvement project at Manchester Veterinary Specialists (MVS) has demonstrated how detailed auditing, improved communication and whole-team engagement can enhance patient safety and efficiency throughout the orthopaedic surgical journey, earning the team a Highly Commended accolade at the RCVS Knowledge Awards.

The project, Enhancing Efficiency and Patient Safety Across the Orthopaedic Surgical Journey, focused on identifying and reducing avoidable waiting periods for patients undergoing orthopaedic procedures. By analysing each stage of the patient pathway, the team sought to minimise unproductive time spent under sedation or general anaesthesia, helping to reduce clinical risk while improving workflow across the hospital.

MVS, a specialist orthopaedic referral centre, mapped the typical surgical patient journey and identified several recurring periods where patients were waiting unnecessarily during the perioperative process. The team then conducted a series of audits over an 18-month period to quantify these delays, implement targeted improvements and evaluate their impact.

Analysis showed that while the hospital was already operating efficiently, there remained opportunities to reduce anaesthetic time through better coordination and communication between teams. Following a dedicated patient safety meeting, a series of practical changes were introduced, including earlier owner discussions around surgical consent, improved communication between clinicians and nursing teams, more proactive theatre management and better coordination of radiography scheduling.

Subsequent audits demonstrated sustained improvements. The team's overall target of reducing cumulative waiting time under sedation or anaesthesia was achieved, with average waiting times falling by 11% in the first re-audit and a further 12% reduction confirmed in the most recent audit cycle. One of the most significant improvements was seen in the transfer of patients to theatre, where waiting times reduced by 59% compared with earlier audit results.

The project also delivered wider benefits beyond patient flow. By improving communication and predictability throughout the working day, the team reported reduced frustration, clearer role expectations and improved staff wellbeing. Operational efficiencies also contributed to a significant reduction in nursing overtime, decreasing by 83% from 53 hours to seven hours over a comparable two-month period.

Throughout the project, MVS placed a strong emphasis on human factors and patient safety culture. Monthly morbidity and mortality-style meetings were introduced to encourage open discussion of systems issues and reduce blame, helping teams identify improvements and strengthen psychological safety across the practice.

Veterinary Anaesthetist Philomena Roe, and Head Nurse Stacey Cox at Manchester Veterinary Specialists said:

One of the most valuable lessons from this project was that improving patient safety is rarely about one major change. Instead, it comes from lots of small improvements, better communication and a willingness to reflect on how our systems work. By bringing different teams together to understand the challenges faced by their colleagues, we were able to reduce unnecessary anaesthetic time, improve efficiency and create a more predictable experience for both patients and staff. We're incredibly proud that this work has been recognised by the RCVS Knowledge Awards and, most importantly, that it has helped us continue to improve the care we provide.

The project further highlighted the importance of quality improvement methodologies in specialist referral practice, demonstrating how audit can be used not only to improve operational efficiency, but also to strengthen patient safety, teamwork and organisational culture.

Findings from the project have been shared internally through practice meetings, patient safety discussions and staff communications, helping to maintain momentum and support future quality improvement initiatives within the hospital.