Live changeover status
A clock starts when the patient leaves theatre, and the screen shows where each team is. If the camera misses a step, staff can mark it by hand.
Shorter changeovers between operations
ORbserve is a camera system for operating theatres. When a case is closing, it tells recovery, cleaning and the porter at the same time, and records how long each part of the changeover takes.
Theatre 3closing at 14:02
Recoveryprepare a bay
Cleaningready to start when the patient leaves
Portercollect the next patient
- Patient leaves theatre
- Recovery, cleaning and porter called together
- Cleaning starts
- Room clean, set-up starts
- Next patient in
19:00changeover in Theatre 3, against a 20:00 target
How it works
- 1
The camera sees the case closing
It picks up the final count and dressing, and gives the next teams a few minutes' notice.
- 2
The circulator confirms
One tap on their phone, and recovery, cleaning and the porter are all called at once.
- 3
Each step is timed
Patient out, cleaning, set-up and next patient in. Nobody has to write the times down.
The theatre in the film is a simulation, with stock footage from Pexels and an AI voice.
What the theatre team sees
Live status during the changeover, a report afterwards, and one screen for the theatre coordinator.
A report after every changeover
Each changeover is split into time spent waiting and time spent working. The report also records the standard theatre times, including anaesthetic start and knife to skin.
16of 30 minutes spent
waiting (example case)
waiting (example case)
All theatres on one screen
The coordinator can see which theatres are operating, which are being turned over, and which changeovers are running late.
Scheduling
ORbserve learns how long cases and changeovers actually take in your theatres, and uses that to help the coordinator plan the day. In development, built on the timings collected during a pilot.
Theatre 3, TuesdayGeneral surgery list
Booked finish 17:30Predicted finish 18:05
BookedPredicted from your theatre's history
- Lap cholecystectomyMr Hendry+15 min
- Inguinal hernia repairMr Hendry−5 min
- Lap appendicectomyMs Raman+6 min
- Cancelled: patient unwell45 min free
- Lap cholecystectomyMs Raman+11 min
- Umbilical hernia repairMr Hendry−2 min
Fill the 12:00 gap?
Umbilical hernia repair from Thursday's waiting list. Predicted 38 min, patient is pre-assessed and available.
Add to listDismiss
Send for the 13:05 patient at 12:40
The changeover is predicted to finish at 13:03, so the patient arrives as the room is ready.
Tell the porterLater
Realistic case times
Predictions come from your own theatres, by procedure and surgeon, rather than the time booked on the list.
Early warning of overruns
By mid-morning you can see whether a list is going to run late, early enough to move a case.
Fill gaps from the waiting list
When a case is cancelled or finishes early, it suggests a suitable patient who can fill the time.
Send for patients at the right time
It tells the porter when to set off, based on when the room is predicted to be clean.
Drink-until times for the ward
Each patient's latest time for clear fluids, updated if the list moves, so nobody fasts for hours longer than needed. The anaesthetist confirms.
Bed and kit checks
A case that needs an ITU, HDU or ward bed, or special kit, is flagged until someone confirms it, so it isn't cancelled on the day.
Morning summary
A few written paragraphs for the coordinator on which lists look likely to overrun, and why.
Scheduled emails
Tomorrow's lists to every team at 7am, overrun warnings mid-morning, and free-slot alerts to the scheduling office.
Sterile field monitoring
During surgery, the same camera watches the instrument tray, back table and surgical site. If something non-sterile touches them, the scrub nurse is paged and the surgeon isn't interrupted. During a pilot these alerts are only logged, not sent.
What else is out there
Video review tools
Record operations so they can be reviewed later. Useful for audits, but no help on the day.
Theatre dashboards
Rely on times typed in by staff, which are often late or missing.
ORbserve
Works during the list: calls the next teams, records the times automatically and monitors the sterile field. No video is stored.
The numbers
291,000
more operations a year could fit in England's theatres with better use of time
NHS Improvement, 2019£14–25
what a minute of idle theatre time can cost
Wales Audit Office; St Mary's, London85%
GIRFT's target for touchtime use: anaesthetic start to the patient leaving theatre, as a share of list time
Getting It Right First TimeEstimate the time you could recover
Put in your own figures. Every box can be changed.
Theatre time recovered each year
0 hours
Valued at£0
Extra cases it could fit0
Who gets what
Each team is only told about its own part of the changeover.
Theatre managers
A turnover report for every case, with the standard timestamps already filled in.
Theatre coordinators
One board for every theatre: which changeovers are late, and what they're waiting for.
Cleaning teams
Called as soon as closure is confirmed, without watching the door or waiting for a phone call.
Porters
Called for the next patient at the right moment, with the ward and bay.
Recovery
Told about five minutes before the patient leaves theatre, so a bay is ready.
Scrub nurses
An optional sterile-field watch that pages the scrub nurse, never the operating surgeon.
Questions from each department
A pilot needs sign-off from several people. Here is what each of them usually asks.
Theatre manager
Will it give us time back?
You get the length of every changeover and what it was waiting on. After a few weeks you can tell whether a change you made helped.
Clinical lead and theatre staff
Will the team accept it?
No video, no faces, no staff scores, and staff can pause it. It goes in only after the theatre team has agreed, and a person always confirms closure.
Information governance
Where does the data go?
Frames are analysed on a computer inside the theatre and discarded. Only event times are kept, and a data protection impact assessment is written with you before anything is installed.
IT
What do you need from us?
For a pilot, nothing on the hospital network or the patient record system. One camera, one laptop, and a small Wi-Fi box for the team's phones that we bring.
Finance
Is it worth paying for?
Use the calculator above with your own numbers. The pilot gives you a measured figure for one theatre before any wider commitment.
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Privacy and staff consent
In 2024, nurses at a Boston hospital objected to cameras put in their theatres without warning. ORbserve is only installed once the theatre team has agreed.
What it does and doesn't do
- No video is keptEach frame is analysed on a computer in the theatre and then discarded.
- No faces, no namesIt watches the back table, tray and operating table, not people.
- No staff scoresReports describe the changeover, not who was slow.
- Staff can pause itOne button, and the pause is logged so the gap is explained.
Where ORbserve is today
- Working prototypeRuns on a webcam and a laptop, and detects the changeover steps and case checkpoints in a simulated theatre.
- Bench testCaught 2 of 2 staged sterile-field breaches with no false alarms, on a mock table.
- Filmed mock theatreReal overhead footage of every step, to tune the detection.
- 60-day pilot in one NHS theatreMeasured against the theatre's own baseline.
- NHS readinessClinical safety case (DCB0129), data protection impact assessment, DTAC.
No video storedBuilt in
Data stays in the theatreBuilt in
Data protection impact assessmentWith each pilot site
Clinical safety case (DCB0129)In preparation
NHS DTACBefore wider rollout
What a pilot involves
One theatre for 60 days, compared with its own figures from before.
Before day 1
Agree it together
Meet the theatre team, agree what is measured, and write the data protection assessment with your IG lead.
Weeks 1–2
Measure only
The camera times every changeover without calling anyone, to give the theatre's own baseline.
Weeks 3–8
Switch on the calls
Recovery, cleaning and the porter get their calls. The coordinator sees the board.
Week 9
Compare and decide
A short report: changeover times before and after, where the waiting went, and what staff thought.
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No connection to hospital systemsNo video keptYou keep the dataRemoved at the end if you don't continue
About ORbserve
I'm Alannam Akabusi. I started ORbserve because a lot of theatre time is lost between operations, often because the next team finds out too late that they're needed. I think a camera and a phone alert can fix much of that without giving staff more to do.
Alannam Akabusi, founder LinkedIn
Request a demo
See ORbserve run a simulated theatre list in a 20-minute video call, and talk through what a pilot in your theatre would involve. We reply within two working days.
Or email alannam@orbserve.co.uk
Information for IG and IT
Documents you can share with your information governance lead or theatre team.
How the camera protects privacy
What it sees, what it keeps, what it never does, and how staff stay in control.
Security and IG summary
Data flow, storage, access and the NHS paperwork for a pilot, on one printable page.
Where the time goes between operations
The four waits inside a changeover, and which one to fix first.
A theatre camera staff can agree to
What we agreed not to do with the camera, and why.
Frequently asked questions
Does ORbserve record video?
No. Each camera frame is analysed on a small computer in the theatre and then thrown away. What's kept is a list of events and times, such as "patient out, 14:02".
Will it replace any staff?
No. It tells people when it's their turn and shows where time was lost. Decisions stay with the team, and a person always confirms closure.
What does a pilot involve?
One theatre for 60 days. We agree it with the theatre team first, set up one camera and a laptop, measure the theatre's changeovers for two weeks as a baseline, then switch on the team calls and compare.
How long does it take to set up?
About an hour in theatre: the camera goes above the operating table, the zones are drawn on screen, and the team's phones are connected. Nothing is installed on hospital computers.
What evidence is there that it works?
Today, a working prototype tested in a simulated theatre and on a mock table. Shorter changeovers from similar tools are reported in the US. ORbserve's own evidence will come from the first NHS pilot, measured against that theatre's baseline.
Is it a medical device?
The changeover features are operational software. The sterile-field alerts would likely be regulated as medical-device software (MHRA), so in a pilot they run in observation mode, logging what they would have flagged, until that route is complete with a clinical partner.