When there is a call to improve OR efficiency, there is a group of usual suspects that gets rounded up, including first-case on-time starts and turn time metrics. But is this truly where we should be focusing our attention?
Intuitively it makes sense that these metrics would be important, but they are really just proxies for the ultimate goal of improving OR efficiency which means doing more cases in prime time, since more cases equals more revenue for the same fixed staffing cost. Turn time and on-time first case-starts are process metrics, but it’s time to shift out focus to outcome metrics.
The importance of this distinction is that driving change on process metrics costs political capital. You’re either pushing nursing staff to turn a room faster (running the risk of reduced quality) or nagging your surgeons to be “on-time.” Reducing turn time by 10 minutes per case alone will not enable you to add more cases in prime time hours. A surgeon being a minute late, or even 10, may not cause the last case to run late and incur overtime.
Rather, the most impactful way of increasing capacity is to first ensuring that blocks are being fully utilized. Then, using automated and well analyzed data, look into those usual suspects for targeted performance improvement opportunities. Perioperative managers should create more tailored plans by surgeon or service that consider a comprehensive picture of current efficiency and then identify the major constraints, rather than trying broad sweeping changes that may not be relevant to many surgeons.
Right now, if you have these data, they probably exist in disperate reports. Their value is strengthened when they are combined with each other, and with block utilization, in one system. Using a platform like Hospital IQ can make it easier to establish specific outcome goals and allow the real-time monitoring of progress towards budgeted volumes.
It is also just as important to quantitatively demonstrate that your OR is at its effective maximum capacity. In this case, targeted performance improvement initiatives are still worthwhile, but they won’t be enough to create the total amount of necessary capacity. Larger and more expensive solutions, like construction or extending staffed hours, may also be considered. Before undertaking these endeavors, it is essential to first definitively prove that your operations are in fact at maximum capacity. Then you can model the impact of such changes in a way that dynamically considers all of your current information to inform the best course of action.
To truly create impactful change regarding OR management and patient flow, it’s time to look past the lineup of usual suspects that you believe are at the heart of delays. Utilizing your data effectively through hospital operational tools like Hospital IQ can help you find the true culprits and truly improve OR efficiency for the long-term.