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“We saved 36,000 minutes of under-scheduled OR time”: How UCHealth improved surgical case length accuracy with iQueue for Operating Rooms
  • Jenessa McElrath, MHA
    Jenessa McElrath, MHA

    Solutions Executive, iQueue for Operating Rooms, LeanTaaS

In their efforts to unlock valuable operating room capacity that would improve patient access to care and staff satisfaction, perioperative leaders from UCHealth developed and deployed the technology that became iQueue for Operating Room’s Case Length Finder tool. Use of the tool improved and promoted better case length accuracy in surgical scheduling, which contributes to overall OR optimization. Continue reading to learn more about the tool and how it has helped UCHealth.

Why case length accuracy is important to surgical scheduling and efficiency

The ability to predict and view likely case lengths with a degree of accuracy is key to efficient OR scheduling. If case lengths are estimated to be too long or too short, surgical schedules become impossible to execute smoothly, negatively impacting staff, surgeons, and patients alike.

Cases that run longer than anticipated result in delayed starts for subsequent cases and eventually unscheduled overtime, contributing to staff burnout and patient dissatisfaction. Those that are shorter than predicted result in idle downtime between scheduled starts, wasting staff time and the use of expensive rooms and equipment. A lack of visibility into the actual amount of time a case takes, along with perceived scarcity of available OR time, drives surgeons and their schedulers to request less time than they really need to accommodate their cases on a given day. This exacerbates inefficient use of OR time and promotes an ongoing scarcity mindset among surgeons.

Using technology to solve for case length accuracy in the OR

Co-developed with UCHealth, the iQueue for Operating Rooms Case Length Finder tool gives the entire OR team visibility into the most accurate predictions of length for different surgical cases. This tool assists surgeons and schedulers in claiming only needed amounts of time, leading to full utilization of the OR, on-time starts, and consistent, reliable shifts for staff.

In a recent webinar with LeanTaaS, leaders from UCHealth hospitals shared their roles in creating the Case Length Finder technology and using it successfully.

“Every time we get better at scheduling cases, that’s a reduction in cost, an improvement in staff and surgeon satisfaction, and less waiting around for our patients. Even more importantly, the better we get, the more high quality care we can provide, allowing us to serve a larger percentage of our community,“ said James Burdette, director of perioperative services at UCHealth in northern Colorado.

UCHealth is a longtime partner of LeanTaaS and has deployed its AI-based iQueue solution suite across multiple locations. Currently over 1,000 UCHealth team members actively use iQueue for Operating Rooms, by which 100,000 additional minutes of OR time were requested in 2022, or the equivalent of 4,500 additional cases performed. UCHealth’s dedication to using Lean principles to optimize operations and better serve patients across the state of Colorado is evident in the case studies below.

Case 1: Poudre Valley Hospital finds the key to discerning case length accuracy

James Burdette, director of perioperative services at UCHealth in northern Colorado (Medical Center of the Rockies, Poudre Valley Hospital, Greeley Hospital) faced an increasing number of surgical cases at Poudre Valley Hospital in 2018. The majority of these cases were scheduled by inaccurate lengths, leading to increased problems with capacity and the inability to accommodate true growth and best serve patients.

He noted that “patient volume was growing fast. We struggled with being able to provide high quality, world class care, as well as meet the needs of our surgeons, patients, and staff when it comes to perioperative time with growth…We found we had more cases that needed to be scheduled and scheduled accurately in order to be cost-effective and efficient.”

Burdette and his team communicated in-depth with surgeons and their schedulers to assess their actual time needs, while comparing these to the case length data offered by the EHR. They discovered that EHR data relied on metrics based on the average case length, which still incorporated outliers and thus skewed the prediction.

As the team had already seen success improving OR schedules through the advanced analytics algorithms provided by iQueue for Operating Rooms, they partnered with the LeanTaaS team to develop a new tool in iQueue called Case Length Finder. The goal was to customize it for surgical office needs and accurately reflect the time cases required by leveraging advanced AI.

“I believe, in the first quarter after implementing this collaborative tool, we were able to save somewhere around 36,000 minutes of under-scheduled time. You can do the math on how many hours that equates to in a given day, and how many more patients we can actually care for,” said Mr. Burdette.

The improvements in case length accuracy meant more cases could be scheduled, and the hospital could accommodate its new growth.

Case 2: Longs Peak Hospital succeeds in transforming its case length accuracy metrics — and its OR staff experience

Several years after the Case Length Finder tool’s creation, Briana Houghton, MHA, BSN, BSBA, CNOR, perioperative business operations manager at UCHealth, saw an opportunity to leverage it to improve operations at another site.

In the summer of 2022, while adapting to the aftermath of COVID, Longs Peak Hospital’s ORs had a case length accuracy of 42% (+/- 15 minutes). Inaccurately scheduled cases impacted case start times, compounded delays throughout the day, and pushed add-on cases far into the evening. This had a profound impact on already-burdened staff. Given existing staffing constraints and the trends of people leaving the health care profession, Ms. Houghton believed that relieving this burden was critical to retaining staff at her hospital.

“We have only four operating rooms at this hospital. When we weren’t scheduling accurately in those, it impacted our ability to get those add-ons in a timely way. Staff were staying later and later into the evening, which increased their overtime immensely,” said Ms. Houghton. “We were coming off the heels of a pandemic that led to a lot of burnout already. Anything we could do to shave off a little bit of that impact, we were looking to make those opportunities a reality.”

Ms. Houghton recognized the importance of all surgeons and schedulers being aligned to a single source of truth with regard to case length accuracy. Like Mr. Burdette, Ms. Houghton engaged with surgeons and staff throughout the hospital to assess their needs and concerns, and obtain their buy-in on the Case Length Finder tool that would help them align on scheduling the appropriate amount of time for their cases.

“We’re always asking, what are ways we can make this a better organization to work for, where we mean what we say and say what we mean? So if you’re scheduled for a 10 or 12-hour shift, you will be leaving when you’re done with that shift,” said Ms. Houghton. “We’re finding an efficient way to run operating rooms and also support our staff.”

Ms. Houghton found that continuing to work closely with surgeons and schedulers, so they could firsthand see how their time utilization metrics improved, helped drive use and engagement with the Case Length Finder tool. Three months after Longs Peak Hospital adopted the tool, its case length accuracy rate (+/15 minutes) steadily rose from 42% to 48%. As schedules became more predictable and steady, staff morale also improved.

To hear Mr. Burdette and Ms. Houghton in conversation and explore their full engagement with technology and OR utilization, view the webinar here.

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