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Transform Spotlight: What’s blocking your OR block utilization? 

At Transform 2022, healthcare leaders and technology experts gathered to discuss using AI to drive better capacity use and higher ROI amid financial and operational pressures. In this session, LeanTaaS’ Austin Trout and Diana Gillogly engaged with an audience of perioperative leaders on developing better surgical block management to open operating room (OR) access.  

View the full session here, and see other perioperative capacity insights here.

Perioperative leaders often struggle to ensure operating room (OR) time is used efficiently. This stems from the common mindset among surgeons that their assigned block time is the only possible way they can access the OR, combined with the block management process often being manual, time-consuming, and based on fleetingly-relevant retrospective data. Hospitals and their perioperative teams are now shifting their approach to instead leverage proactive, data driven insights to support stronger and smoother OR utilization. 

At our session, we engaged with 140 perioperative leaders and stakeholders to explore their most pressing concerns and the best ways they are navigating them. 

The biggest barriers to achieving better use of OR block time, revealed by OR leaders

Members of our session’s audience each ranked the top two operational challenges they faced in block scheduling. The highest-ranked challenges included finding time needed by new surgeons and service lines, and lack of open OR time for add-on cases; followed closely by time consuming block utilization reporting processes and too-frequent requests for additional block time.

All these challenges are interrelated and impact the growth and health of the OR, and it only takes one getting out of control to exacerbate all the others. 

New surgeons who immediately perceive they cannot schedule the time they need will hoard whatever open time they can find. In turn, established surgeons with block time feel more reluctant to release theirs. Inefficient scheduling processes and inadequate reporting and analytics lead to a lack of visibility into the time that is actually available or could be. This reinforces the mindset that limited block time is the only way surgeons can access the OR, which benefits no one. 

The comprehensive nature of these challenges, related to both the personnel and the technology availability in the OR, requires an equally comprehensive response.

The pillars of better surgical block management – technology, process, and people

The three pillars to an effective surgical block management solution are as interlinked as our audiences’ top-of-mind problems. 

Technology for block scheduling should create increased access to operating rooms while facilitating the efficient use of existing block time. To overcome scheduling limitations, it should also share actionable insights across stakeholders to drive collaboration and incisive decisions. The objective of any technology platform should be to offer a fair, transparent, and surgeon-centric decision support framework that has incontrovertible evidence to create accountability for rightsizing block schedules. 

To be effective, all technology must be based on an established process that works effectively for OR stakeholders. This should be established to help dictate how to optimize block time, deeply engage with the right data, and create OR access for as many surgeons as possible.

In order to establish a working process, ORs must account for and engage people. The process must factor in surgeons’ unique needs for time allotments and metrics, while providing their scheduling staff with the full and accurate information they need to execute on these. 

iQueue for Operating Rooms, an AI-based solution that uses historical and real-time OR data to display an up-to-date “single source of truth” across the OR and make capacity recommendations for the future, is designed to address and supplement these pillars to achieve better surgical block utilization. 

Technology to support informed process: iQueue for Operating Rooms addresses surgical block challenges head on

iQueue for Operating Rooms is built on effective scheduling processes that optimally distribute time so that it is used productively. The iQueue Collect module runs the detailed data needed to identify which unused block time is actually reusable, or “Collectable”. This makes free time more visible to surgeons and schedulers and shows context for block time utilization metrics that might appear low. Surgeons may in fact be finishing cases efficiently within assigned block time or in more complex service lines, need more turnover time between cases.

The Allocate module in turn accounts for those individual utilization behaviors, drilling deep into whether a surgeon is overbooking a given room, regularly working outside prime hours, or frequently using open time when they have an assigned block. The tool then determines how much time that surgeon realistically needs to complete their caseload and which days are best, so that scheduling teams can distribute Collectable Time accordingly. 

Better surgical block management means ensuring process and technology work for – and with – people

The critical challenges cited by the OR audience all relate to people, and surgeons’ scarcity mindset stems from their legitimate concerns and needs. To maximize the value of an analytics tool like iQueue, users must be able to trust the data and have full visibility into information like their own utilization performance and available surgical time for additional cases.

Recognizing this, the LeanTaaS team aligns with OR teams throughout an iQueue implementation and beyond, socializing the tool and its features, sitting in on block committee meetings to help facilitate block schedule decisions, and helping interpret utilization data to drive optimal utilization of the OR.

One hospital took this people-centric approach to deploying iQueue’s insights to improve its block management process and saw significant results.  

Case study: an academic hospital improves surgical block management with a people-based approach to iQueue for Operating Rooms 

One LeanTaaS customer, a 60-OR hospital in a major Midwestern academic health system, had a high case volume and large number of resources, but struggled to fully utilize open time in order to grow. The Director of Business Operations in the space recognized much of this was caused by limited visibility and access to open time, leading to unused open time and cases shifting into non-prime hours. Attempts to change this and create better block capacity were reactive. The director knew that to alleviate this problem, his stakeholders needed access to actionable, reliable, and accurate data. Once teams were armed with this data, he created incentive programs to encourage collaboration, so stakeholders would devise data-driven processes and practices. 

When adopting iQueue, the director made clear to all surgeons and schedulers that the goal of the new technology and process was to help them get the time they needed and remove the scarcity mindset. A cross-functional committee, including senior leaders, was formed to assess and strategize on block usage, utilization rules, and scheduling guidelines. As surgeons and their scheduling teams took action based on the data, and saw directly how their metrics improved and new case time opened up, they were motivated to continue using the tool and unlock further gains. 

After one fiscal year using iQueue, the hospital saw: 

  • 11% increase in block utilization
  • 16% increase in prime time utilization 
  • 57% decrease in abandoned blocks (blocks that go unused with little time left to repurpose)

In this case, iQueue’s technology gave stakeholders the data they wanted to see and inspired them to improve block management as a team. The new committee process ensured they had the right decision-making power to act on that data. Most importantly, the people engaged in that process rid themselves of their scarcity mindset and created a culture of transparency. Their comprehensive solution, based on combining people, process, and technology, removed the hospital’s roadblocks to better block utilization and enabled the hospital to run a more efficient OR.

For more on iQueue’s functionality and how it fits into the process of better block management, and more details on the hospital’s success story, view the full session here.

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