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OR “flip rooms” are nothing to flip out about

  • Debra Tse
    Debra Tse

    Product Implementation Manager, Operating Rooms, LeanTaaS

Awarding surgeons a flip room, or a two-room, two-team setting where the surgeon can alternate rooms to perform cases – two rooms, two teams, and one surgeon, where only the surgeon moves room to room – is a common practice and often a driving force in recruiting and retaining in-demand surgeons and service lines. But flip rooms do entail some drawbacks. From a surgeon’s perspective, flip rooms greatly improve their efficiency and time management. Conversely from the hospital’s perspective, flip rooms generally lower overall utilization and consume twice the resources (space, OR time, staff, etc.) as a single room. Therefore, the decision to award them is subjected to high levels of scrutiny. In analyzing flip rooms, hospital leaders must answer the basic question: is it worthwhile to assign two rooms to a single surgeon, practice, or service line?

Debate continues about the benefits and risks of the flip room model as it relates to differing points of view regarding overlapping, concurrent, dual, or simultaneous procedure policies and definitions. With this in mind, if a hospital policy allows for flip rooms and leaders are interested in awarding them, some additional factors are relevant to a well-constructed flip room plan.

Beyond the strategic implications of assigning a flip room block, some helpful foundational guidelines for determining which surgeons or service lines are good candidates for a flip room are:

  • Short case lengths: This will minimize the idle time between when the room is set-up and when the next patient is wheeled in.
  • Low variability in case length: If case duration is relatively consistent and predictable, then it is easier to optimize the schedule.
  • Ability to use flip rooms efficiently: Having another surgeon or credentialed individual (e.g., fellow, PA, resident, NP, RNFA) who can close while the surgeon starts the next case improves efficiency, if the practice is permitted at the facility.
  • Like cases: Another popular criterion is requiring flip rooms to be used for like cases (e.g., all cases in the rooms must be total hip replacements). While this may have some operational, staffing, and safety benefits, like cases are typically not a huge driver of overall OR efficiency.

While a flip room cannot feasibly achieve the same level of utilization as a standalone room, a well-run program can achieve reliable utilization that justifies the expense.

These are guidelines to consider when defining your flip room utilization goals:

  • Know your benchmark. Use your benchmark for standard block utilization. In this example, we use 80% and assume the first room meets this mark.
  • Understand the worst case. Now suppose the second flip room is never used — i.e. the worst-case scenario. Then the average utilization of both rooms would be 40%.
  • Define your goal. For example, a goal for the flip room to create at least a 50% improvement to the worst-case scenario produces a combined room goal of 60% utilization. Anything below this mark is too close to the second room never being used at all.
  • Releasing block time. Note that because the overall goals for flip rooms are adjusted, the expectation is the surgeon will be scrupulous about releasing time — either both rooms in the event of a day away from the OR, or one of their two rooms because of lower-than-expected volume.

Using an operations management platform like iQueue for Operating Rooms provides the data needed to inform flip room policy as it relates to OR utilization goals.

Awarding a flip room block is a strategic choice and one that should continuously be scrutinized. With the right data to keep abreast of OR flip room utilization, perioperative leaders have the tools to monitor utilization and make data-driven adjustments that optimize efficiency, maximize revenue, and create surgeon satisfaction by using all available options.

For an in-depth guide to determining the best circumstances for flip room use as well as criteria and goals, download our ebook 

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