Transforming operating room utilization at Rush, part 2: plugging data analytics into surgical management

Recognizing its challenges in surgical data governance and operating room (OR) utilization, the 671-bed Rush University Medical Center, which performs 30,000 surgeries per year in 37 operating rooms, began its transformation by aligning its operations, administration, and clinical teams toward the same goals. But Rush needed further resources to make surgical data visible and actionable to all the stakeholders who used it in their daily functions. 

To learn more on how Rush began working with its people and processes to overcome data credibility challenges, read Part 1 here.  

As the Rush team proceeded with opening up OR access, it was clear we needed more than the tools and data we had in order to strengthen data governance and improve our OR utilization. Specifically, we knew we needed to:

• Optimize OR utilization and access during prime time hours
• Enhance OR block management and our surgeon’s engagement with it
• Create an effective mechanism for new surgeons to show their demand for OR time
• Plan for the future with automated forecasting reports, to not only diagnose issues, but predict outcomes and prescribe action
• Provide our teams with a single source of truth for data

Our EMR was not equipped to deliver the level of surgical data analytics, visibility, or action we needed to address these. Building some predictive and prescriptive analytics tools ourselves was possible, but would take years of construction, data management, and evaluation – and with all that time and investment, we still would not be able to produce a solution with the power we needed. Investing in a partner who was already equipped to solve these issues made the most sense. 

We reviewed many different opportunities to develop our surgical data analytics, including partnerships, consultants, and even the ability to simply create new Tableau dashboards. Ultimately we chose LeanTaaS’ iQueue for Operating Rooms, which I am now convinced is the best decision we could have made. 

How iQueue’s analytics and visualizer functions transformed Rush’s ORs 

iQueue analyzed and displayed the OR data we had, and through its modules and functions, addressed the very specific roadblocks we faced, including: 

• Limited access to the OR: Offering both automated and manual time releases, iQueue’s Exchange marketplace gave surgeons and schedulers a simple, efficient mechanism to reserve time they need and release blocks they did not need. We ensured there were no repercussions for surgeons’ releasing time, which alleviated the scarcity mindset that had impeded OR access in the past, and also meant surgeons would actually use the blocks they did have.
• Low block utilization, plus lack of accountability: iQueue clearly shows ongoing block usage, to promote accountability, motivate improved performance from individuals, and support better decision making. The Collect module, which identifies OR time that can be realistically reused or reallocated, offers a clear course of action to this end, and we could establish a definition of “collectable” time that suited our surgeons’ unique needs.
• Lack of data transparency and clear metrics: iQueue’s Analyze module provides universal access to clearly defined KPIs, as well as metrics like case volume, prime time and staffed room utilization, add-ons and cancellations, and case lengths. These help standardize our OR performance review process, while the predictive analytics functions showing likely future trends help us determine our best path forward. 

Overall, the iQueue tools provided Rush surgical teams with data that is credible, relevant, actionable, and always accessible. This was unquestionably the single source of truth we needed. 

Building iQueue into Rush’s processes, culture, and growth

Releasing so many tools and so much information to our teams without a system that supported it, however, would only promote further chaos and communication breakdowns. To avoid this, we adopted a surgeon-centered approach to using iQueue. 

At our monthly surgical chair check-ins, we continued to review iQueue-sourced KPIs and scorecards and made performance reviews comprehensive, allowing our chairs more access to data and inviting admins to participate as partners in improving OR utilization. Together we can examine ongoing patterns or problems revealed by iQueue, such as a particular block on a given day regularly not being used, assess the issue with a block owner, and determine an appropriate solution. This approach also incorporates all the information we need for effective future planning, including admins’ insights on which surgeons might need more block time or whose practice would be growing. iQueue’s predictive analytics help us establish the most efficient way to assign that time going forward. 

With this full perspective, we have been able to establish functions that directly open OR access. Looking at our historical trends of OR and block time utilization, we identified opportunities for OR optimization and customized iQueue to support these. We established auto-release deadlines, timed manual release reminders, and a unique definition of “collectable” or reusable block time that could be released, all aligned to real patterns for surgeons in different service lines. We also set Exchange to reflect actual operational realities, so for instance in a staffing crunch, only the rooms that could be staffed would show as available. These steps increase available OR capacity in Exchange and allow room for add-on cases. 

The actions we’ve taken around iQueue have reflected our original goals of strengthening our data governance to open OR access. These are particularly critical now, as the operating rooms we do have are bustling with cases, and while we’re building a new outpatient pavilion, we maintain a risk of running out of space. 

The results: unlocking the Rush OR 

So far we have succeeded in using the data offered by iQueue in opening and optimizing the surgical capacity we already have. Results we have seen over the past two fiscal years include: 

• A 7% increase in OR block utilization, with steady increases quarter-over-quarter
• An 8% increase in manual time release
• A total 6% increase in staffed room utilization

The graph below shows a dramatic decrease in unused surgical blocks following the implementation of iQueue, which in turn shifted our scarcity mindset to one of plenty and allowed surgeons to release their blocks. 

Rush is only just beginning our journey with iQueue, and I am confident we will continue improving our capacity in the future. 

Lessons learned from Rush’s iQueue for Operating Rooms implementation: 

Three key takeaways from our journey improving data governance and OR access with iQueue: 

1. Operations, clinical, and admin teams should view themselves as partners to each other, with common goals we can work toward together. All stakeholders have critical information, insights, and solutions to contribute. 
2. Provide data access and availability to everyone. At Rush, we regularly meet with surgical chairs, but everyone can reference the data they need from iQueue at all times. 
3. Always include surgeons in their own performance measurement, and be sure this is based on truly comprehensive metrics. Surgeons will feel empowered to improve their own performance when they see how their actions impact their results, and believe they are being measured accurately. 

For more details on how Rush implemented iQueue, specific cases of their success, and new ongoing OR capacity improvement projects, including surgery clearance optimization and robotics use, view Alena’s entire presentation here.