In today’s healthcare landscape, operational efficiency is not a luxury — it is a necessity, according to Paul Hinchey, MD, COO of Cleveland-based University Hospitals.
Operational challenges, including access to care and capacity constraints, remain top of mind for health system executives in 2025.
Becker’s connected with Dr. Hinchey and three other health system COOs to gain insights into the strategies they have implemented over the past year to address these challenges and improve key metrics, including length of stay and patient volumes.
Standardization at University Hospitals
University Hospitals has embraced a shift in mindset, redesigning care delivery to be more scalable, reliable and cost-effective, Dr. Hinchey said.
Standardization is at the foundation of this effort at the 21-hospital system.
“While often undervalued, standardization is the key to reducing costly variability across our system,” he said. “It empowers us to improve outcomes, increase efficiency and enhance patient experience. The more consistent we are, the more predictable and trustworthy our care becomes — and that builds loyalty and drives growth.”
One example of standardization is how the system redesigned its IV fluid usage pathways after a hurricane-induced supply chain disruption.
“By creating consistent, evidence-based protocols, we cut IV utilization in half — saving approximately $1 million without compromising care,” he said. “We also standardized perioperative services by treating all operating rooms as one systemwide resource. That strategic alignment allowed us to increase OR utilization by nearly 10%, pushing our system average above 85%.”
Healthcare will always require some degree of customization, Dr. Hinchey added.
“But by intentionally designing systems around where consistency can exist, we unlock significant gains — in cost, time, outcomes and experience,” he said. “It’s not just about doing things the same way — it’s about doing them the best way.”
Data-driven access at McLaren Health Care
Grand Blanc, Mich.-based McLaren Health Care has used standardized processes and data-driven strategies to improve patient access, Chad Grant, COO of the 12-hospital system, told Becker’s.
The health system began its efforts by building an enterprise data warehouse to leverage analytics and reporting. This helped identify opportunities for improvement and establish standardized procedures across its medical group, ambulatory clinics, diagnostic imaging centers and emergency departments.
Standardizing equipment utilization and offering online patient self-scheduling have been major initiatives, Mr. Grant said. Online scheduling, available at several sites of care, has reduced wait times and enhanced patient convenience.
“On the radiology side, we perform about 1.5 million imaging procedures a year — about 60% of those elective or outpatient,” he said. “We had a year-over-year volume increase of 11% due to increased access simply by standardizing our approaches and optimizing how we’re utilizing equipment resources, as well as people resources from a scheduling perspective.”
McLaren also implemented predictive analytics to better align staffing with anticipated patient volumes.
“These are extremely powerful tools for our clinical leaders and our administrative leaders in our hospitals,” Mr. Grant said. “It’s allowed us to get to an optimal alignment of our people resources and schedule staff at the right time to match the anticipated patient volumes. It helps us improve our labor efficiency at a time when people are our greatest asset.”
Capacity expansions at UCSF Health
San Francisco-based UCSF Health has deployed a coordinated strategy to improve operational flow and address capacity constraints through expansions and enhanced visibility, COO Sheila Antrum told Becker’s.
“We streamlined inpatient discharge and post-acute planning to reduce length of stay and began shifting appropriate emergency and medicine admissions from our flagship hospital to a newly integrated community site,” Ms. Antrum said. “We also increased real-time visibility into systemwide capacity to support faster placement and transfers.”
To free up inpatient beds, the 1,290-bed system expanded outpatient centers that combine imaging, surgery and pharmacy services. This enabled a 20% increase in outpatient surgery cases since opening San Francisco’s largest ambulatory surgery center in August.
Discharges to its lounge have increased 10% in less than a year, helping open up emergency department bed capacity, Ms. Antrum added.
“These efforts have reduced delays for incoming patients and maintained a favorable length of stay index even as patient acuity has risen,” she said.
Breaking down silos at Nebraska Medicine
About a year ago, Omaha-based Nebraska Medicine — which includes more than 800 beds across two hospitals — launched targeted teams to focus on specific areas needing improvement based on key performance indicators and objectives and key results.
“We look at people, process and technology, always in that order, to understand what’s working, and what needs to change,” Michael Ash, MD, president and COO of Nebraska Medicine, told Becker’s.
The work done by these teams has led to improvements in several critical focus areas, including length of stay. By enhancing efficiency throughout hospital stays and addressing barriers to discharge, the health system increased capacity without adding beds or hiring more staff, Dr. Ash said.
“That, in turn, has allowed us to increase our facility transfers from outside organizations by 13%, as well as decrease our overall length of stay while maintaining — and in some cases, increasing — our case mix index,” he said.
These initiatives have also proven effective in the perioperative space, improving accuracy and understanding of staffing needs for surgical cases.
“AI is also playing a role there,” Dr. Ash said. “Actually looking at the chart and what is said is going to be done isn’t always inclusive of what all is planned. Our AI tool also looks at other demographic information on the patient and prior performances of that surgical team, which helps us better predict how long it will take for that surgical case, which helps with staffing requirements.”
Dr. Ash emphasized that in implementing AI and other tools to improve operations, teams must stay agile and aligned. He also highlighted the importance of focusing on leading indicators, such as OKRs, to drive meaningful change.
“Silos are great if you want to go home on time,” Dr. Ash said. “They’re horrible if you want to be transformational and safe. Work against those silos, be part of understanding the problem, defining the solution, and then work together to achieve it.”