Amid increasing pressure to improve surgical access and operational efficiency, Tacoma, Wash.-based MultiCare Health System completed 3,200 additional surgical cases in a single year without adding new operating rooms.
By standardizing workflows across 13 hospitals, the organization increased staffed room utilization by 25% and uncovered previously hidden capacity.
During a recent webinar hosted by Becker’s Healthcare and LeanTaaS, leaders from MultiCare, detailed the system’s playbook for moving from fragmentation to systemness.
Here are key takeaways from their discussion:
1. Aligning people and processes
When Chris Hunt, MBA, MSHA, BSN, RN, CSSM, NEA-BC, associate vice president of perioperative services at MultiCare stepped into his system-level role, he saw a timely opportunity to bring greater alignment to perioperative operations across the system. Individual sites had developed strong local practices, but varied performance metrics and operating models signaled the need for a more unified, systemwide approach.
“The OR was still very much a facility-level decision,” said Mr. Hunt. “There was no system-wide visibility into operations, no unified strategy for access or block allocation and very limited physician engagement.”
To address this, Mr. Hunt established an OR leadership forum that brought surgical leaders together regularly to compare practices, build trust and begin creating a shared vision. This became the foundation for standardizing workflows and decision-making.
2. Creating consistency
One of the first major steps toward systemness was building a unified governance structure supported by standardized key performance indicators and shared definitions. That meant every OR was not just tracking the same metrics, such as first case on-time starts or primetime utilization, but also interpreting them the same way.
“A big part of this was clarifying what we meant by good OR access,” Mr. Hunt said. “Surgeons, nurses, anesthesia and administrators all define that differently, so we needed shared principles and prioritization rules.”
MultiCare implemented LeanTaaS’ iQueue for Operating Rooms across all surgical sites, allowing leaders to identify and repurpose underutilized OR time in real time. The data platform served as a unifying tool enabling equitable access, exposing inefficiencies and supporting targeted improvements at the site level.
“I’m not spending hours slicing and dicing data anymore,” said Katrina Freitag, MN, RN, nurse manager of surgical services at MultiCare Covington Medical Center. “It’s intuitive and accessible. In meetings, I can pull up what I need in seconds and use it to drive decisions.”
The results followed quickly. In the West Pierce region alone, MultiCare added 1,600 surgical cases within a year of standardizing operations and leveraging iQueue. Systemwide, that figure was 3,200 additional cases, representing up to $12 million in additional contribution margin, according to Mr. Hunt.
3. Systemness doesn’t mean one-size-fits-all
Both speakers emphasized that successful standardization required flexibility. Local leaders were empowered to tailor solutions to their specific needs while still aligning with systemwide goals.
When Ms. Freitag’s facility at Covington expanded pediatric ENT services, for example, she worked closely with Mr. Hunt to access project management support and align stakeholders across departments.
“We weren’t experts in pediatrics, and it was a heavy lift,” Ms. Freitag shared. “Chris brought in the structure and I could focus on leading my team.”
4. The importance of change management
Ultimately, the foundation of MultiCare’s transformation wasn’t just analytics, it was collaboration. Leaders across sites began connecting directly, sharing solutions and supporting each other.
“To me, that’s the secret sauce,” Mr. Hunt said. “When you know your colleagues, not just their names, but who they are and what they care about, the systemness part becomes easy.”
Looking ahead, MultiCare plans to expand its access playbook across the full health system, continuing to optimize capacity while preparing for potential reimbursement changes. And thanks to the organization’s focus on increased systemeness, Ms. Freitag feels equipped to adapt quickly.
“We’re already seeing this vertical ramp in surgical volumes,” Ms. Freitag said. “It feels good to know we have the support, the tools and the trust to keep growing.”
