Operating room inefficiency is easy to miss. It rarely looks like an empty schedule — instead, it hides in unused blocks, late releases and reactive processes that leave capacity and revenue untapped even as surgical demand climbs. For many health systems, the usual fixes like emails, spreadsheets and manual handoffs only add friction, obscuring where time is actually available and hindering volume growth.
Fairfax, Va.-based Inova Health System took a different approach, rebuilding its block release process around predictive orchestration and reaching a 46% release fill rate, a 20% increase in released OR minutes and a 3% gain in prime-time utilization within its first year.
In a webinar hosted by Becker’s Healthcare and sponsored by LeanTaaS, three Inova leaders shared how they surfaced available OR time and matched it to the surgeons who needed it. The panelists were:
- Caity Butler, MSN, RN, manager of centralized surgical scheduling at Inova
- Jane Yang, director of operations for perioperative services at Inova
- Kelly Connolly, senior director of the surgery service line at Inova
Below are four takeaways from their conversation.
Note: Quotes have been lightly edited for length and clarity.
1. Open time on the board didn’t mean open access
A persistent complaint among Inova surgeons was that they couldn’t get cases scheduled, even as leaders saw unused time on the grid. The disconnect traced to scheduling bottlenecks — blocks that didn’t release until one to three days before surgery, or the day of, leaving no runway to add cases.
That scarcity pushed surgeons to “hoard time,” Ms. Connolly said. In partnering with LeanTaaS and implementing iQueue for Operating Rooms, Inova used data to see how far in advance cases were actually booked and reset block release windows accordingly, extending some from zero days to seven, 14 or 21.
2. Releasing time earlier backfilled the schedule
The change produced a result that ran against surgeons’ instincts: releasing blocks further ahead of surgery, rather than holding them until the last minute, opened up more usable capacity, not less. OR case volume rose 8% for the top 10 requestors, released OR minutes rose 20%, and 46% of that recovered time was backfilled with new volume.
The behavior shift behind those numbers mattered as much as the figures themselves; once surgeons saw more open time on the schedule, they grew willing to release their own blocks rather than guard them, widening the pool of available time across the system.
“When surgeons release time, their peers — and down the line, they themselves — also have access to more open time,” Ms. Yang said, describing a cycle that feeds itself.
3. A united leadership front carried surgeons through skepticism
Surgeons were initially resistant to earlier block releases, fearing the effect on their cases, so Inova leaned on aligned leadership to hold the course.
“Our senior leadership team at Inova really bought into the LeanTaaS model and had a unified front in telling surgeons, ‘You have to give us three months,'” Ms. Connolly said. That commitment came with a promise to address any concerns that remained once the three months were up — assurance enough for surgeons to give the model a chance.
4. New governance and daily discipline kept the gains in place
Inova replaced its block committees with utilization committees, shifting the focus from who owned a block to how well allocated time was used, and standardized how data was presented across sites. Schedulers who once compiled utilization figures across spreadsheets could pull them up in seconds, and teams moved to frequent huddles to stay ahead of pending cases.
“Instead of reverting back to our old habits where cases are just sitting and waiting, we’re being proactive,” Ms. Butler said.
Finding capacity before building it
Inova’s experience suggests the real constraint on surgical volume often isn’t physical OR capacity but how released time is surfaced and reassigned. By pairing earlier block releases with centralized scheduling, transparent data and disciplined governance, the system turned idle time into new cases — without the capital outlay of new physical infrastructure.
“We’re not conjuring up any more ORs out of thin air,” Ms. Yang said. “It’s really important in this environment that we’re just using what we have.”
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