In a year, 166.67 days is a substantial amount of time to waste, but hospitals everywhere leave that time on the operating table by inefficiently managing their surgical blocks and letting poor surgical utilization rates go unaddressed.
Brian Watha, associate vice president of consulting services at Surgical Directions, and Michael Besedick, engagement manager at Surgical Directions, explained how meaningful metrics combined with excellent governance can improve operating room function and improve financial performance during a Feb. 19 webinar hosted by Becker's Hospital Review and sponsored by Surgical Directions.
The problem is the data
Imagine your operating rooms were sitting empty for 45 percent of the year, what would you do? First, you'd want to find out how this happened. Surgical Directions was brought into an academic medical center on the East Coast to analyze the system's OR efficiency and improve its surgical services. The hospital assigned blocks to its surgical team and left it to the surgeons to determine how to utilize the blocks.
For example, a longtime surgeon has three ideal block times. He routinely schedules patients for the first two days and leaves the third block time mostly empty. When the surgeon was in the OR, he operated his entire block, working diligently and on time. The EHR system gave him a high utilization rate, despite his third block sitting mostly empty because when he was in the OR, he worked the entire time. But the data was inefficient and while his OR utilization was high, keeping the third block open and not releasing the block to other elective cases created an inefficiency. The problem was the data.
Because the block sat open, the surgeon's adjusted-utilization rate was around 66.7 percent. Even when he had cases and utilized the block, the unutilized time was never taken into account. Expand that unutilized time throughout an entire system, and a hospital is left with 45 percent of a year where their ORs sat open.
"This speaks to the disparity that exists between OR utilization and block utilization," Mr. Besedick said. "... The question we ask the systems is, 'Is this the world you want to live in? Do you want over 4,000 hours over a six month period of suboptimal usage?'""
Allowing surgeons to release unused surgical blocks to r surgeons looking to grow their practice can optimize resource utilization and drive revenue for health systems. In the above example, the hospital's adjusted-utilization rate sat at 40 percent. When the blocks were proactively reassigned the rate increased to 89 percent.
"People aren't going to change unless you measure it," Mr. Watha said. "I worked with a nurse and she always said, 'Don't expect it until you expect it.' The reality is we can make all these rules on our expected target utilization, but if I don't have a thoughtful mechanism to have data that surgeons can agree and make decisions on, it [won't work]."
The key driver of any analytical experiment is having the full support of leadership on board. When Surgical Directions goes to implement a metric-driven system, without having the support of corporate leadership on board none of the analytical changes take place. Mr. Watha highlighted the importance of a reciprocal relationship between administration and surgical staff. When implementing a plan that relies on metrics, he added that changes were more likely to stick when presented by a peer, a surgeon talking to a surgeon or a nurse to a nurse.
So when examining OR utilization rates, consider how many more cases your surgical team could fit in, if you had 4,000 more hours per year to operate?
View a recording of this webinar here.