Custom OT management software for Karnataka hospitals — OT scheduling with surgeon and anaesthetist assignment, WHO Surgical Safety Checklist enforcement, pre-operative assessment, intra-operative documentation, anaesthesia records, implant tracking with serial numbers, post-operative recovery scoring, and OT utilisation analytics. Part of the OneCity 120-module Hospital ERP.
Get a Free Demo WhatsApp UsThe operation theatre is the most resource-intensive and schedule-critical area of a hospital. An OT complex running 6 theatres across multiple surgical specialties must coordinate surgeon availability, anaesthetist assignment, OT nurse staffing, instrument sterilisation turnaround, equipment allocation, and patient flow from pre-op holding to theatre to post-anaesthesia care — simultaneously, all day. Paper-based OT scheduling and documentation is the most common cause of OT inefficiency, cancellations, and the documentation gaps that create medico-legal exposure after adverse surgical events.
Module 10 of the OneCity Hospital ERP manages the complete surgical workflow: OT list booking and resource allocation, pre-operative assessment documentation, WHO Surgical Safety Checklist enforcement at Sign In, Time Out, and Sign Out, intra-operative surgical and anaesthesia documentation, implant tracking with device serial numbers for traceability, blood transfusion log during surgery, post-operative recovery monitoring with Aldrete scoring, and OT utilisation analytics. Every surgical case from list to recovery is documented in one connected system, shared in real time by the surgical team, anaesthetist, scrub nurse, and recovery nurse.
For NABH accreditation, the OT module covers the Surgical Care (COP) standards: pre-operative marking and timeout documentation, instrument and sponge count records, blood product transfusion documentation, and post-operative handover. For implant traceability under Indian Medical Device Rules 2017 and CE/ISO 13485 device tracking requirements, the serial number tracking in Module 10 provides the mandatory device traceability record. OneCity Technologies Pvt. Ltd (CIN: U72100KA2009PTC048911), Bengaluru, Mangaluru, Mysuru. We have implemented OT management software for multi-specialty hospitals in Karnataka since 2017, across a range of OT complexes from 2-theatre nursing homes to 8-theatre tertiary hospitals. The implementation approach for OT software follows a structured parallel-run methodology identical to what we described for billing and ICU — configuration and template setup, staff training on test cases, one-week parallel documentation alongside paper, then full digital transition with the paper chart retained only for downtime backup. The critical success factor in every OT implementation has been surgical team buy-in, particularly from the senior surgeons and anaesthetists who set the culture for how the OT documentation is treated. We invest significant time in pre-implementation engagement with the surgical team leadership, because a WHO checklist enforcement feature that surgeons actively circumvent is worse than no feature at all.
The WHO Surgical Safety Checklist has three phases: Sign In (before anaesthesia induction), Time Out (before skin incision), and Sign Out (before the patient leaves the OT). Each phase has specific verification steps — patient identity, procedure, site marking, anaesthesia equipment check, allergy confirmation, instrument count, specimen labelling. Module 10 enforces each phase as a mandatory screen that must be completed before the next phase can be documented. The checklist cannot be skipped or backdated. This is the software implementation of the patient safety standard that WHO’s Safe Surgery initiative established. Reference: WHO Safe Surgery.
All features from the live OneCity Advanced Hospital ERP, deployed 2026.
Surgeon requests OT slot from the IPD or clinic screen, selecting the date, theatre, procedure, estimated duration, and equipment requirements. The OT coordinator confirms the booking with anaesthetist assignment, scrub nurse, and instrument tray. The OT list for each theatre is visible as a daily schedule, with case order and timing. Cancellation or postponement is logged with reason. Elective, emergency, and add-on case classification. OT utilisation tracked by theatre, surgeon, and specialty for management reporting.
Structured pre-operative assessment form: patient fitness confirmation, anaesthesia fitness (ASA classification), airway assessment (Mallampati scoring), allergy and current medication review, surgical site marking confirmation, consent verification, fasting status, and pre-operative investigations check. The form is completed by the surgeon and anaesthetist independently, with both sign-offs required before the patient is marked ready for OT. Incomplete pre-operative assessment prevents the surgical case from being listed as ready, reducing day-of-surgery cancellations.
Complete intra-operative anaesthesia record: pre-induction check, induction agents and doses, airway management (type, grade, technique), maintenance agents (volatile, TIVA, regional), reversal, and emergence. Vitals documented at defined intervals throughout the case. Drug and fluid administered with doses and timestamps. Airway events and complications logged. Post-anaesthesia care unit (PACU) handover note generated from the intra-operative record. Anaesthesia record is the anaesthetist’s medicolegal documentation for every case.
Every implant used in surgery is recorded with the device name, manufacturer, batch number, serial number, expiry date, and patient UHID. This device-patient linkage is the traceability record required under Indian Medical Device Rules 2017 for Class C and D implants (orthopaedic, cardiac, neurosurgical). The implant sticker from the device packaging is scanned or manually entered at the time of use. Implant cost is automatically added to the patient’s surgical bill. Post-market surveillance: if a device recall is issued, the system can identify all patients who received that batch or serial range.
PACU (post-anaesthesia care unit) documentation: vital signs at 15-minute intervals, consciousness level, pain score, nausea, oxygen requirement, and Aldrete score calculated from these parameters. Aldrete score ≥9 is the standard discharge criterion from PACU to ward. The recovery nurse documents each assessment and the Aldrete score is calculated automatically. Discharge from PACU is documented with the final score, receiving ward nurse signature, and time. Unexpected PACU events or adverse reactions are logged with a structured incident form linked to Module 83 (Incident Reporting).
OT utilisation rate by theatre, specialty, and surgeon. Average case duration vs scheduled duration (scheduling accuracy). First case start time compliance. Turnover time between cases. Cancellation and postponement rates with reasons. Emergency case impact on elective list. Surgeon-wise case volume and duration. These reports let the OT manager and hospital administration optimise theatre allocation, identify scheduling inefficiencies, and benchmark OT productivity. NABH requires documented evidence of OT utilisation monitoring as part of the Quality Management standards.
Adverse surgical events — wrong-site surgery, retained surgical instruments, unrecognised anaesthetic complications, implant traceability failures — are among the most serious patient safety incidents a hospital faces and the most legally significant. OT management software addresses patient safety at the documentation and process level, enforcing the checks that prevent these events rather than documenting them after they occur.
The WHO Surgical Safety Checklist, when implemented correctly, has been shown in multiple studies to reduce post-operative complications and mortality. The key word is “correctly” — a paper checklist that is filled in retrospectively, incompletely, or signed without the team actually performing the checks is not the intervention that produces safety outcomes. Software-enforced checklists that require real-time completion, with each team member’s individual acknowledgment recorded and timestamped, are the implementation that actually changes surgical outcomes.
Instrument and sponge count documentation in Module 10 creates a permanent record that the count was performed and confirmed correct before skin closure and again before the patient left the OT. In the event of a retained surgical item claim, this record is the primary evidence. In its absence, the hospital has no documented defence regardless of what actually happened in the theatre.
The Indian Medical Device Rules 2017 and the subsequent CDSCO regulations create specific traceability obligations for implantable medical devices. Class C and D devices (including orthopaedic implants, cardiac devices, neurosurgical implants, and vascular devices) must be traceable from manufacturer to patient. Module 10’s implant tracking, combined with the hospital’s purchase records in Module 17, provides this traceability chain: device batch and serial number at purchase, storage in inventory, and use in a specific patient surgery. Reference: CDSCO Medical Device Rules.
The OT module connects to six other ERP modules, making it the most highly integrated department in the hospital system.
Module 5 (IPD Admission): The surgical case is booked from the IPD patient record. Patient demographics, diagnosis, and pre-operative investigations are pulled from the existing record — no re-entry of patient information in the OT system.
Module 11 (Lab LIS): Pre-operative investigation results (blood group, coagulation, haemoglobin) are visible in the pre-operative assessment form from the LIS, confirming that the investigations have been done and are within acceptable ranges before the case proceeds.
Module 13 (Pharmacy): Anaesthetic drugs and surgical consumables dispensed during the case are tracked from the OT pharmacy satellite. Drug usage is recorded in the anaesthesia record and pushed to billing automatically.
Module 14 (Billing): Surgical procedure charges, implant costs, anaesthesia charges, and OT facility charges are accumulated in the patient’s bill automatically as the case is documented. The billing team does not need to independently collect OT charges.
Module 9 (ICU): Post-surgical ICU admissions transfer the intra-operative summary to the ICU team. The surgeon’s intra-operative notes and the anaesthesia record are available to the ICU intensivist immediately.
Module 53 (Infection Control): Surgical site infection (SSI) surveillance tracks post-operative wound infections, linked back to the OT record to identify procedure, theatre, and surgical team associations.
See the full 120-module Hospital ERP, and our ICU management software for post-surgical intensive care documentation, and the hospital management software overview.
An OT complex is the hospital’s highest-revenue-per-hour department and its most expensive to run. A 6-theatre OT complex with full surgical teams, anaesthesia, nursing, sterilisation, and equipment costs the hospital money every hour it is not running. Yet most hospitals in Karnataka do not have precise data on their OT utilisation rates, first-case start time compliance, or average turnover times — the metrics that determine whether the OT is recovering its cost or running at a deficit.
The OT utilisation report in Module 10 generates these metrics automatically from the case documentation. Utilisation rate (actual surgical time as a percentage of available OT time) benchmarked against the 75–80% target that efficient OT complexes achieve. First-case start time compliance (what percentage of first cases started within 15 minutes of scheduled time). Average turnover time (from previous patient leaving OT to next patient on table). These numbers, reviewed weekly by the OT manager and surgical services director, identify the specific inefficiencies that reduce OT productivity — whether it is delayed pre-operative assessments, late surgeon arrivals, sterilisation turnaround bottlenecks, or scheduling mismatches between estimated and actual case duration.
Marginal improvements in OT utilisation have significant financial impact. Increasing utilisation from 65% to 75% in a 6-theatre complex running 10 hours per day adds 60 minutes of surgical time per theatre per day — at average surgical revenue rates, this represents substantial additional revenue annually. The OT software investment is justified by efficiency gains of this scale alone, before the patient safety and compliance benefits are factored in.
Module 10’s OT documentation templates are configurable by surgical specialty, so the documentation fields match the clinical requirements of each procedure type.
General Surgery: Standard laparoscopic and open procedure documentation with drain placement, specimen handling, and stoma marking if applicable.
Orthopaedics: Implant-heavy documentation with emphasis on serial number tracking for prostheses, plates, screws, and nails. Tourniquet time documentation for limb procedures. C-arm usage logging.
Cardiac Surgery: Cardiopulmonary bypass time, cross-clamp time, cannulation details, and perfusionist documentation. Integration with the cardiac ICU record.
Neurosurgery: Microscope usage, neuronavigation system usage, neural monitoring documentation, and cerebrospinal fluid management records.
Obstetrics (LSCS): Consent for sterilisation documentation, foetal presentation, Apgar scores, and neonatal handover integrated with the NICU record.
Urology, ENT, Ophthalmology: Day surgery workflow support with rapid turnaround documentation designed for high-volume, shorter-duration procedures where OT throughput is the primary metric.
The same core OT module — scheduling, WHO checklist, anaesthesia record, billing integration — underlies all specialties, with specialty-specific fields configured in the procedure template rather than requiring a different software product per specialty. For the full ERP context, see the OneCity 120-module Hospital ERP. For post-surgical care, see ICU management software. For a cost overview, see our hospital software cost guide.
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Yes. The WHO Surgical Safety Checklist is implemented as three mandatory screens: Sign In (before anaesthesia), Time Out (before incision), and Sign Out (before the patient leaves OT). Each screen requires individual team member acknowledgments in real time. The screens cannot be backdated or skipped. If the Time Out has not been completed, the system does not allow the intra-operative documentation to proceed. This enforcement is the difference between a checklist that is completed correctly and one that is signed off for compliance without the team actually performing the checks.
At the time of implant use in surgery, the scrub nurse scans or manually enters the device barcode from the packaging. The system records the device name, manufacturer, batch number, serial number, expiry date, and links it to the patient UHID and the surgical case. This record is the device-patient traceability required under Indian Medical Device Rules 2017 for Class C and D implants. The implant cost is automatically added to the patient’s bill. If a device recall is issued, the system identifies all patients who received devices from the recalled batch or serial range.
Yes. Emergency cases are registered directly in the OT module with an emergency flag, bypassing the elective scheduling queue. The WHO Surgical Safety Checklist is still enforced for emergency cases — a shorter emergency checklist protocol is available for life-threatening emergencies where the standard Sign In steps must be abbreviated, with the abbreviated protocol documented and the reason recorded. Emergency case documentation follows the same structure as elective cases but with a efficient booking workflow that can be completed in minutes.
Yes. When a post-surgical patient is admitted to the ICU, the intra-operative anaesthesia record transfers to the ICU module as the admission record. The ICU intensivist sees the induction agents, intra-operative events, drugs administered, fluid balance, and any intra-operative complications before making the first ICU management decisions. This handover is immediate and complete — the ICU team does not rely on verbal handover from the anaesthetist or a handwritten summary.
Most same-day surgical cancellations occur because pre-operative requirements were not completed: investigations not done, anaesthesia fitness not confirmed, consent not obtained, fasting status not verified, or the patient’s clinical condition having changed. Module 10’s pre-operative assessment checklist makes each of these requirements a mandatory field that must be completed and confirmed before the case is listed as ready for surgery. The OT scheduler sees which cases are pre-operatively complete and which have outstanding items, allowing cancellations to be identified days before the surgical date rather than on the morning of surgery.
Yes. Day surgery cases use an abbreviated workflow: a simplified pre-operative check, same-day admission and discharge, and a simplified recovery record. The WHO Surgical Safety Checklist is still enforced. Billing for day surgery captures procedure, anaesthesia, consumables, and OT facility charges against the single-day admission. High-volume day surgery specialties like ophthalmology cataract lists and ENT lists use a batch scheduling view where multiple short cases are sequenced in the same theatre with automated turnover time tracking. OT utilisation for day surgery lists is tracked separately from inpatient surgical lists in the performance reports.
Yes. Blood products requested during surgery are ordered from the blood bank module (Module 31) via the OT screen. The blood bank issues the product with the cross-match verification record. The transfusion is documented in the anaesthesia record with the unit number, blood group, and transfusion start and end time. Any transfusion reaction during surgery is documented immediately and triggers an adverse event report (Module 83) and a blood bank investigation. The complete transfusion record for a surgical case is available in both the OT record and the blood bank module, linked by the patient UHID and the surgical case.
See the OT scheduling and surgical management module — with screenshots, feature documentation, and implementation details for Karnataka hospitals.
Tell us your OT complex — number of theatres, surgical specialties, current scheduling and documentation method, and implant tracking requirements. Free assessment and fixed-price proposal within 5 business days.
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