Beyond surgical block utilization: how McLaren Health Care is transforming its OR operations through expanded metrics

At the LeanTaaS Transform Winter 2021 event, Binesh Patel, MD, Chief Medical Officer, McLaren Health Care’s Flint Hospital, and Tyler Baker, Product Implementation Manager, LeanTaaS, iQueue for Operating Rooms, discussed how McLaren Health Care used iQueue to develop metrics that gave context to surgical block time utilization and improved how surgeons used time, rooms, and resources. 

Missed the event? View the whole webinar, or read a transcript.

The context:
McLaren Health Care is a fully integrated health delivery system with $5.1 billion in revenue in FY2019. It consists of 15 acute care hospitals with 3,185 licensed beds and a network of 305+ inpatient hospital and ambulatory care facilities. McLaren offers Graduate Medical Education programs with 654 Medical Students, interns, residents, and fellows, and employs 26,000+ employees. 

McLaren Health Care’s systemwide OR challenges included:

• Limited OR access: Physician offices were reluctant to release their excess block time, and there was no effective way to advertise “open” time to grow the surgeon base.
• Low accountability for surgical block utilization: Leaders had difficulty holding block owners accountable using a one-dimensional metric like surgical block utilization. Influence, rather than data, drove allocation. 
• Limited visibility and transparency: The process of producing and distributing hundreds of reports was time consuming. Not everyone had easy access to the reports, and there was limited engagement in metrics overall, as well as a lack of data to support effective action.

What McLaren Health Care did:
McLaren chose iQueue for Operating Rooms to support better visibility and distribution of data. The phased implementation across the system began with a pilot roll out in May 2020. Its early success accelerated iQueue’s expansion across McLaren’s hospitals. After the successful pilot, four additional locations went live in late 2021 and are continuing into 2022.

LeanTaaS provided McLaren with a solution they believed would address their key challenges. 

Using predictive and prescriptive analytics to maximize OR utilization

• “OpenTable” like functionality: iQueue for Operating Rooms made it easier for surgeons to request time and release blocks, increasing access and visibility to open operating time. Available on mobile devices and in the cloud, iQueue gave surgeons and schedulers a streamlined, usable request and release process.
• Automated nudges to release time or add cases: Using booking patterns to incentivize early releases and identify potential unused capacity, iQueue for Operating Rooms created flexibility in surgery scheduling to support variability in surgeon volume. Its surgeon-centric messaging increased release proactivity.
• Framework for and execution of data-driven culture: Using machine learning models, iQueue for Operating Rooms factors in number of cases scheduled and other data to create alerts for those accountable for staffing and OR management to help them plan for productivity. 
• Powerful mobile experience: Admins can access data anywhere and anytime, providing deep drill-downs into meaningful metrics, such as which scheduling practices correspond to a pattern of delays in case start times, that drive decision making. They can use the tool to easily “push” messages to the right users. 
• Custom metrics: LeanTaaS worked with McLaren Health Care to narrow in on the metrics, like comparative levels of room or equipment utilization or surgical volume forecasts, that were most meaningful to governance or physician users.

Finding value beyond EHR capabilities 

• Enhanced accountability: Surgeons and schedulers can use the iQueue Collect module to identify truly reusable surgical block time. 
• Decision support: The Visualizer tool made metrics like room utilization, staffed rooms, and surgical block utilization clearly visible, and generated decision reports to easily socialize that data to those who needed it. 

The results:
McLaren Health Care has seen tremendous utilization of iQueue at the four sites where it is active. Each site is unique and each has used the solution to gain efficiencies in different ways.

Overall, since launching iQueue in early 2020, McLaren has seen the following outcomes:

• 2,300 approved requests
• Over 250,000 minutes released
• Over 1,000 releases of block time
• 50% reduction in undocumented delays

What McLaren describes as “the biggest shining star” in all of these metrics is proactivity. All of these requests and releases are made well into three weeks in advance, addressing scheduling volatility and allowing staffing to be more consistent.  

What others can learn from McLaren Health Care:

• McLaren’s initiative to drive EHR “Best Practices” ensured delays were properly documented
• Accurate documentation allowed McLaren leadership to identify opportunities and establish action plans
• This let McLaren reduce undocumented delays through EHR hygiene and focus on documentation
• Better data facilitates data-driven unbiased conversations with McLaren surgeons

View the whole webinar here, or learn more about iQueue for Operating Rooms.