The Hidden Seconds: Micro-Innovations That Can Save Time and Lives in Hospitals and Operating Theatres
Every second matters in a hospital, but almost no one is counting them.
As an anaesthesia doctor in training, I sit at the unique intersection of every moving part in the operating theatre. I watch patients arrive late because of a delayed lift. I see nurses sprint to find gloves. I wait while beds are adjusted, documents are fetched, monitors are untangled, and teams orient themselves to unfamiliar layouts. This goes from the biggest tertiary hospitals to the smallest.
And each time I watch those micro-delays accumulate, I think:
This could have been avoided.
This is costing us time.
This could cost a life.
What Are the Hidden Seconds?
They’re the 8 minutes lost waiting for a patient to arrive from a ward on another floor.
They’re the 40 seconds it takes to find a laryngoscope buried under an avalanche of packaging.
They’re the 15-second pause when no one knows who’s responsible for calling transport.
They’re the 2-minute chaos when the wrong paperwork is printed or not printed at all.
Individually, these moments seem insignificant.
But add them up over a full theatre list, or a full hospital week and you start to see the iceberg.
Why We Don’t See Them
Hospitals are built to manage complexity - but not always to optimise flow.
We measure utilisation rates, overtime hours, and cancellation counts. But we almost never measure:
Distance from ward to OT
Number of lift calls per patient journey
Time between ‘ready for theatre’ and ‘arrival at OT bay’
Number of times a nurse needs to leave the room mid-case to grab a missing item
We’ve normalised inefficiency.
We accept delays.
We absorb chaos as part of the job.
The McDonald’s Effect: Lessons From Outside Medicine
In McDonald’s, every motion is choreographed.
In Formula 1, every pit stop is rehearsed down to milliseconds.
In aviation, every checklist is tested and timed.
Yet in hospitals, we redesign workflows once a decade, if ever.
We build new operating theatres but place glove boxes too high.
We hire talented staff and then make them wait for lifts, search for gowns, and untangle cables.
We’ve poured billions into equipment.
Now it's time to look at movement, access, and time.
Small Innovations That Change Everything
Here’s what I’m working on through my research and audits, and what I believe every hospital should measure, and what you can measure in your hospital right now.
Bed Movement Time
How long from “ready on ward” to “in OT bay”?
Which route is longest? Which lift is slowest? Why is nobody tracking this?
Drawer and Cart Design
Can your airway trolley be opened with one hand while holding an Ambu bag?
Are emergency drugs in the same place every time in every theatre?
Glove Proximity
How close is your PPE to the patient, is highly used PPE (gloves) within 2 seconds of staff.
Are teams wasting time walking back and forth between rooms?
Handover Precision
Can we make the pre-theatre checklist smarter, shorter, and tied to actual flow?
Seconds Can Save Lives
We often say "we're doing our best."
But what if our systems are making that "best" harder than it needs to be?
The future of surgery, anaesthesia, and emergency medicine won't just be about skill or tech.
It will be about flow. About systems that support, not sabotage, the brilliance of our people.
If we can save just 30 seconds per case, across thousands of cases per year -
We save time, we save money, and yes -
We save lives.
Let’s stop leaving efficiency to chance.
Let’s make it intentional.
Let’s count the hidden seconds and start using them.
Want to be part of this conversation?
I’m launching a pilot study on operating theatre flow in remote and metro hospitals, please share this blog with someone who you think needs to read this.
If you're interested in collaborating, testing, or simply learning more - reach out, Im building the Tyto flow system for hospital efficiency - please reach out on my contact page below.
Together, we can reimagine how hospitals move.
- Josh
