Between 2020 and 2023, Tacoma General Hospital increased staffed room utilization by 16%, added 1,600 surgical cases and grew prime time OR use by 18%, all without building new space or hiring more staff. At Oregon Health & Science University, a similar approach added one surgical case per OR per day and freed up 25 hours of weekly staffing time.
These results underscore a growing movement among hospitals to unlock hidden OR capacity using technology, better governance and data-driven workflows. Faced with rising surgical demand and constrained resources, health systems are deploying technology to drive surgical throughput and reduce waste.
During the 2025 Becker’s Healthcare Perioperative Summit, leaders from MultiCare, OHSU, Silver Cross Hospital and Duke Health shared how targeted OR reinvention, not expansion, is delivering measurable returns.
These were among the overarching themes during three sessions sponsored by LeanTaaS:
- Better Margins, Better Mission: Aligning Surgical Operations with Financial Insight
- Transforming Surgical Operations to Withstand Policy Shocks
- Patient Prep and Pre-Admission Testing (PAT) Automation as a Capacity and Staffing Optimization Lever
Across these discussions, healthcare executives explored important, transformative ideas such as:
- How to unlock measurable ROI from existing ORs without new capital projects or additional staff
- The importance of workforce engagement and change management to OR optimization
- How data-driven decision-making reduces wait times for surgeries, minimizes cancellations and creates a work environment clinicians love
- Why partnerships and purpose-built OR optimization solutions deliver value
Main Themes
Underused capacity is a multimillion-dollar problem
Healthcare organizations in the U.S. deliver clinical sophistication that rivals any in the world. But when it comes to operations, particularly in the perioperative space, many face entrenched challenges.
Underutilized block time needs to be released more efficiently to maximize capacity. Pre-op workflows and scheduling processes must be strengthened to reduce last-minute cancellations that disrupt care and strain resources. Staffing and room assignments must also align more precisely with case volumes to prevent costly mismatches.
These inefficiencies affect more than just day-to-day logistics, they directly impact financial performance and growth. Anesthesia resources in particular, are a top concern for many leaders. Once ORs are staffed, making full use of that capacity becomes essential.
“When you look at prime time utilization, how do you make sure you’re filling the rooms that you’re staffing? You can’t waste a minute of anesthesia resources,” said Chris Hunt, RN, assistant vice president of perioperative services at MultiCare’s Tacoma General Hospital. “If you’re off by one room, one day a week, it’s a million-dollar mistake.”
In addition to capacity challenges, last minute surgical cancellations drain OR capacity, drive up costs and strain clinical teams. Breakdowns in patient prep and pre-admission testing processes are often the source. Pre-op calls are time consuming and when they fail, it results in significant risk. If patients arrive at the wrong time or haven’t completed their prep, surgeries get cancelled.
“Once you have a surgery cancellation, you have poorer outcomes, your surgery schedule becomes a mess and it affects the bottom line,” said Kristen Lund, RN, director, OR/MSPU scheduling and pre-operative medicine clinic at OHSU, said.
Using AI and technology to support patient prep and pre-admission testing can help. An optimized process leads to better outcomes, shorter lengths of stay and faster recoveries.
Data is the cornerstone
Data holds the key to solving many perioperative challenges but only when it’s accessible and actionable. While electronic health records generate vast amounts of information, translating that data into operational improvements remains a challenge for many hospitals.
At Oregon Health & Science University in Portland, executives were pushing for increased procedure volume, yet new surgeons couldn’t secure OR time for patients. Despite having detailed block utilization data, the organization struggled to use it effectively to drive change.
Every month, the team looked at thick stacks of Excel spreadsheets containing extensive block utilization information, but OR time was never taken away from surgeons. “We had all this data and we did nothing with it. It became the burning platform,” Ms. Lund said.
To improve OR block utilization, OHSU implemented LeanTaaS’ iQueue for Operating Rooms. This change resulted in their teams now getting available data to the right teams.
Within nine months of deployment, OHSU added an extra case per OR per day each month. The organization has seen a 2% improvement in block utilization year-over-year, a 3% increase in prime time utilization and 25 hours of time saved per week in staffing coordination.
Reflecting on OHSU’s experience, Ms. Lund emphasized the importance of building a strong data foundation before layering on new technology. With reliable data in place, teams can better identify where to focus their efforts.
“We shouldn’t normalize bad processes,” Ms. Lund said. “If we don’t have good data to make decisions, then we need to get good data. And if we don’t have tools, we need to get them.”
Blending financial and operational data can help hospitals make more precise, margin-driven decisions such as whether to expand a service line or invest further in specific procedures.
However, most of the data currently available is based on high-level averages, which can obscure important details. For instance, when evaluating case volume for procedures like total knee arthroplasties or bronchoscopies, financial metrics are often aggregated across surgeons, even though individual providers may have different case times or billing practices, which directly impact margins.
“The information is usually at such an aggregated level that it’s not actionable,” said Neil Ray, MD, chief innovation and technology officer at Duke Health in Durham, N.C. “When you take things into account, like operational time, turnover time and payer mix, you get a different answer about the margins you can generate.”
To improve decision-making, LeanTaaS is integrating cost accounting, clinical, revenue cycle, supply chain and operational data. Linking transaction-level data to individual cases allows teams to model site specialization strategies, identify payer leakage and minimize preventable write-offs.
“Marrying operational and financial data will help us fine tune and target interventions,” Dr. Ray said.
Successful change management leads to results
Silver Cross Hospital in New Lenox, Ill., has been live with iQueue for just over three months. Since implementation, case scheduling adoption has jumped from 3% to 65%, staffed room utilization has improved by 9%, turnover time has decreased by 12%, and surgical denials are down 6%.
Because most surgeons at Silver Cross aren’t employed by the hospital, early success hinged on building strong relationships and ensuring equitable access to scheduling tools. “It wouldn’t be a fair playing field for everyone,” said Kathleen Meyer, RN, manager of pre-procedural operations. “The platform is something every provider can access. That’s one of the main reasons we brought it in.”
Leaders collaborated closely with office schedulers to clarify workflows and foster trust. “We used to be adversaries. Now we are truly allies in getting cases scheduled,” Ms. Meyer added.
LeanTaaS partnered with each clinic to analyze scheduling behaviors and tailor implementation accordingly, a people-first approach that helped accelerate adoption.
Silver Cross isn’t alone in this shift. Many hospitals initially rely on native EHR functionality to optimize ORs, but such tools often limit provider access and don’t align with perioperative goals. At Oregon Health & Science University, for instance, existing EHR metrics didn’t reflect the needs of surgical teams. And at MultiCare, leaders found the pace of EHR innovation too slow, often requiring 12 to 18 months to onboard new features.
Effective perioperative leadership today means aligning operational change with measurable results. Through structured change management and workflow optimization, hospitals are driving gains in efficiency, workforce engagement and patient outcomes.
