At Lee Health (Fort Myers, Fla.), we operate across four hospital campuses and four surgery centers. When including our General Surgery ASC in that mix, we perform more than 48,000 surgeries each year. Like many health systems, we were seeing rising demand and increasing pressure to grow, without the ability to simply build more operating rooms. The question in front of us was not how to add capacity, but how to better use what we already had.
For us, that meant reframing access as a strategic growth lever, not just an operational challenge.
Fragmented processes, limited visibility, and hidden capacity
Before this work began, our perioperative environment operated somewhat independently across sites. We had four hospitals, each with its own processes, reporting, and approach to managing block time. There was not a single, shared view of capacity, and visibility into what was available was limited.
Schedulers sometimes had difficulty placing cases. Clinic staff did not always have an easy way to see open time. Surgeons were managing block time that was not always fully utilized. That created friction at times across teams and could lead to delays for patients.
What made this especially challenging was that access could feel constrained even when usable time existed across the system. We had capacity, but it was not always easy to see clearly or coordinate across sites. At the same time, we operate in a competitive market, and growth depends on being able to offer timely access. We needed to approach this differently.
Rethinking access across the system
We made a deliberate decision to treat operating room access as an enterprise asset. That shift changed how we approached everything that followed. Instead of thinking about block time as belonging to individual surgeons or sites, we began managing it as a shared resource that needed visibility, accountability, and coordination.
A big part of that was what we call systemness. Surgeons move across sites, and when each location operates differently, it can create inefficiencies. We needed to operate as one system, with consistent workflows, shared data, and alignment from the executive level all the way down to the operational teams.
We partnered with LeanTaaS to implement iQueue for Operating Rooms to give us real-time visibility into capacity and utilization. For the first time, surgeons, schedulers, and leaders were all looking at the same data. Everyone could see what was available, and the data was consistent across all four hospitals.
But visibility alone does not change behavior. Governance does. Our executive team made optimization a priority and helped drive alignment across the system. We established shared governance, including a system-wide block committee, so decisions about allocation and utilization were based on credible, shared data.
Once people trusted the data and could see it clearly, behavior started to shift. Surgeons became more proactive about releasing unused time. Schedulers were able to act with more confidence. Clinic teams could see availability and schedule more effectively. The friction we had experienced began to ease.
Early results and sustained gains across the system
Within the first 100 days, we saw that shift translate into real results. We added more than 1,100 cases compared to the prior year period, alongside clear behavior change in how teams managed block time. We had 737 block releases, creating more than 3,500 hours of available time, along with over 2,000 open-time requests that secured nearly 2,900 additional hours. That growth came from better use of what we already had, not from adding more rooms or resources.
As we continued, the impact sustained and expanded. Since we began this work, case volume has increased by 11 percent and block utilization has improved by 6 percent, while unused block time has decreased by 20 percent. We also saw a meaningful improvement in scheduling turnaround time, with cases moving from request to schedule in less than eight hours in many instances, compared to up to 48 hours previously.
We also saw a shift in how our teams approached scheduling. Much of the work had been manual, with schedulers re-entering case information, which slowed things down and introduced the potential for errors. With visibility and governance in place, we were able to take the next step and automate parts of execution.
With synchronized scheduling, approved cases can now be pushed directly into our EHR. To date, we have completed more than 19,000 automated case pushes, averaging about 187 per day. This has reduced repetitive work and improved accuracy, saving more than 6,500 hours annually and allowing us to redirect the equivalent of over three FTEs to higher-value work. Our schedulers can now focus more on coordination and communication rather than manual data entry. For patients, especially those waiting on time-sensitive procedures, that speed and consistency makes a meaningful difference.
What it took to make this work
This was not plug and play. Building trust in the data took time. Standardizing processes across four hospitals required alignment. We also had to shift from a culture where people went looking for information to one where data was pushed to them in real time.
The biggest lesson for me is that technology alone does not drive transformation. It is the people, the process, and the accountability that make it work. The technology gives you the visibility and the tools, but the real change comes from how you use it together as a system.
Looking ahead, we are continuing to build on this foundation. There are opportunities around real-time visibility, staffing optimization, and patient readiness that will take this even further.
Many health systems respond to growth by adding capacity. What we have learned is that there is significant opportunity in optimizing the capacity you already have. When people can see it, trust it, and act on it together, growth follows.
That is the shift we made at Lee Health, and it continues to shape how we think about surgical operations today.
I went into greater detail on this work during my presentation at Transform Hospital Operations Summit last month during Becker’s Annual Meeting in Chicago. You can access that session on demand here.
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