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Adopting Innovation In The OR: Lessons in Leading And Managing Change Webinar Transcript


MARIANNE BISKUP: Welcome to today’s session entitled Adopting. Innovation in the OR: Lessons in Leading and Managing Change. In case you’re wondering who this disembodied voice is, my name is Marianne Biskup. I’m the Events Manager here at LeanTaas iQueue. So before we start, I have a few housekeeping notes for all of you. If you have any questions– and we strongly encourage questions, we really love engagement during webinars– you can text a question. The number is 630-884-5493. Or you can email us, that is 


You also noticed that you’re all muted. If you have any questions during the presentation, there’s a Q&A box in the upper right hand corner. Feel free to use that. As I mentioned just a few seconds ago, we really love your questions. Also, we will send out a link to this webinar shortly after we conclude today’s webinar. And now, I’d like to introduce our presenters. We have Ashley Walsh, she’s our. Director of Client Services, iQueue for OR, and Alyssa. Trocchio, former Manager of Operations, Surgical. Services at OhioHealth, and most recently, a brand new hire for us. She’s currently our. Client Services Manager here at iQueue LeanTaas. So take it away. 


ASHLEY WALSH: Thanks, Marianne. Good morning, everyone. My name is Ashley Walsh. As Marianne said, I am the. Director of Client Services here at LeanTaas, specifically over iQueue for OR. I’m so excited to have my copresenter today, Alyssa Trocchio, and we’re here to talk to you about Alyssa’s experience in adopting innovation and managing change in the operating room, specifically her experiences she had at OhioHealth. 


So as far as agenda for today, first, we’re going to have Alyssa introduce OhioHealth, find out who they are in central Ohio, what kind of a system they are, how big, and what were the challenges that they had that led to the implementation of iQueue for OR. I’m going to be happy to teach you a little bit about those tools, spend a little bit of time on each tool that was implemented at OhioHealth, but then turn it back to Alyssa to really talk to you about what change management looked like and how they manage change at OhioHealth. 


Of course, anyone on this call is probably familiar with the perioperative environment, so I think it goes without saying that the stakes are very high. Operating rooms are a valuable resource for all of our hospitals in that we are producing a majority of the revenue for our hospitals. So managing that space is critical for the success of the overall ecosystem of the hospital. So without further ado, I want to introduce Alyssa and have her talk to us a little bit about OhioHealth. 


ALYSSA TROCCHIO: Thanks, Ashley. As Marianne and. Ashley both mentioned, I am the former. Manager of Operations for Surgical Services at. Riverside Methodist Hospital. Riverside is part of the OhioHealth system. You can see the facts on the slide in front of you. It’s a non-for-profit community-based health system out of central Ohio. It is comprised of 10 hospitals and roughly 28,000 associates. And the system, as a whole, does roughly 80,000 surgeries a year. So Riverside, where I formerly worked, has a roughly 38 ORs. We have 30 in the main, and then three as a same-day surgery center, and complete 25,000 surgeries a year. 


We are the tertiary hub and located in upper Arlington, which is just north of downtown Columbus, Ohio. We see just over 500,000 admissions a year and just over 100,000 admissions. And the system, as a whole, does about $3.7 billion in net revenue. With that, I’m going to talk a little bit about the challenges Riverside’s OR had and some of the macro level challenges that are facing OhioHealth as a system. As I’m sure many of you on the call know, we at Riverside had challenges sharing visibility into our operating schedule in particular. We had a very outdated process for surgeons to release and request time, and this created challenges allowing them to operate at Riverside, in general. 


We did a very good job with block allocation, but there’s always opportunity for improvement. In addition to the visibility and the operating metrics, we also had challenges with how we allocated time. Much like, I’m sure, a lot of systems across the country, we were fairly blocked. A lot of surgeons, a lot of our OR time was created or comprised of block time that was allocated to surgeons, and then their offices or themselves did not want to release that time. And so, because we did not have release time, we didn’t have time for surgeons to request time. 


In addition, we didn’t have robust analytics that helped us better understand how we could or where our areas of opportunity were. And that’s really why we leaned on some of the tools that iQueue were able to present to us. Not only did we have challenges in the OR setting, we also have– Columbus lives in a little bit of a bubble, and so, we also had macro challenges that are starting to face the health system. So we had the system we’re preparing for the imminent reimbursement challenges that were likely to come. And in order to do that, Ashley is going to talk to you a little bit about how these tools helped prepare us for the future. 


One of the things that we wanted to share before Ashley does get into the details of the tool, we wanted to share with you the tremendous success that iQueue was able to give us. We saw more than double the amount of blocks released on a monthly basis than we did prior to having iQueue. This is important for us because, as I mentioned, we were able to free up that capacity, which then allowed us to have more than 50% of our surgeons who don’t have block time submit an approved request for them to operate at Riverside. 


So they were able to get their patients on, where, prior, they may not have been able to. In addition, one of the other things that we wanted to note was that we would typically have 30 elective add-on patients waiting at a week out to have surgery. We saw that decrease over six months to three patients waiting. What Ashley is going to go through and describe to you is how we were able to do that and the tools that we were able to use. 


ASHLEY WALSH: Awesome. Thanks, Alyssa. So just to remind everyone, please, please text us for more information at 630-884-5493, or feel free to email us at if you’re interested in hearing even more detail about these tools, if you want a one-on-one session with any of our team members or are interested in inquiring about what it takes to implement these tools at your organization. So Alyssa’s experience at OhioHealth, I think, is like many across the country. I have spent a good deal of my career working in the perioperative environment myself, specifically in a large health system comprised of academic and community hospitals. 


The challenges were the same. So visibility into time is a challenge. How we allocate time is a challenge. And transparency in reporting is a challenge. So addressing those three issues specifically, we implemented these three tools with OhioHealth. So the first tool is Exchange. That’s module number one for us. Think of Exchange like. OpenTable for operating rooms. Alyssa mentioned that outdated process of visibility into the OR. Even if your health system is entirely on the same EHR, I guarantee there’s still a challenge of when is time available, do I have time, as a surgeon, can I add on another case, can I do surgeries on a day I don’t have block. Such a challenge. 


Exchange allows you that visibility into the OR schedule whether you are or are not on the same EHR. It doesn’t matter. These are cloud-based tools. So moving on to tool number two, that’s Collect. So Alyssa touched on something that I think is interesting. She said that, overall, they did a pretty good job of allocating blocks across their hospital, but that they had the opportunity to improve that. I think that’s powerful. A lot of hospitals that we work with don’t necessarily say the same things. They did a great job of allocating block. No matter what, the time that is spent on allocating block time, managing it, reviewing it, is tremendous. 


Even if you do a good job of it, I guarantee your teams are spending dozens and dozens, if not hundreds, of hours preparing the right reports and having the right conversations. I’m going to show you a different way to do that that is faster, more transparent, more reliable, and more valid data to use. And third is just that transparency into reporting period, and we call that Analyze. I’m sure that many of you are familiar or have tried to build your own dashboards or used dashboards in your EHR. I would love to have more conversations with you on how many people actually use it. Do all your physicians use it? 


I don’t want people to underestimate the power in mobile technologies and making data more transparent for everyone, from the CEO to the physician assistant to the nurse in the office to the manager of the operating room. All right. Let’s dive into each of those tools a little bit more. I also don’t see any questions coming through the chat. Please feel free to text us or chat some questions, and we’ll be happy to stop and answer those along the way. So let’s talk about. Exchange a little bit more. So Exchange really our answer to enabling more open time into your operating rooms, making it really easy to release and request time. 


So we talked about the problem. The problem is limited visibility into the OR schedule. Imagine a world where a physician can, at his or her leisure, open up their mobile device and look and see when block time or OR time is available for a case or block. Maybe someone just had a case to add on, maybe they want a whole block of time. No matter which one they’re looking for, imagine they can just go onto the web or their mobile and look and see what’s open. We want to reduce that manual, cumbersome process, and we want to help hospitals streamline their overall scheduling process. 


So, many times, ORs have a disjointed way that they release or request time. Maybe an email to the charge nurse, to the OR scheduler, some back and forth communication, lots of phone calls. I have never walked into a scheduling office where the phone does not ring off the hook. We want to help reduce that and make it more automated and trackable, if you will. So really taking down a streamline in the process and making it all trackable. So what does it look like? I’m going to show you what it looks like on a mobile device. So this is the view if a physician is looking for his or her time themselves, for when is time available on the OR. 


Again, these are cloud-based tools. So they can go on, they can choose a location– maybe there are multiple locations available where they have privileges– they can estimate their time needed when they would like to operate, and right there pass up a bunch of different opportunities for them. You may be asking, well, what about this restriction or that restriction? Restrictions are constraints. Constraints can be built into a tool. So the Go Request Time– and you notice right there, there’s a number of names listed. When time is requested, all of the people that need to get that communication automatically get that communication that a request was submitted. 


Maybe you know a specific date that you want to do surgery. Maybe there’s no time available, but that’s the best day. You can set an alert, like an Amazon Wish List. What happens then is you’ll get a notification if it becomes available. For [INAUDIBLE] you can easily go in, see all the blocked time that is allocated to you as a provider or your group. If it so happens that you already have cases scheduled when you’re trying to release, we’ll highlight that for you. And then a quick one-click of a button, a notification is sent to OR schedulers, physician office staff members, physicians. Whoever needs that information can get that information. So it’s very, very simple. At the same time, it doesn’t have to be done by the physician. It can be done by his or her scheduler, MA, assistant. Whomever is a part of the scheduling process can do this on behalf of the physician. 


What happens when we implement this tool at a hospital such as OhioHealth? No one loses. There’s really no penalty. I know block time is precious, and I know physicians often are reluctant to release that time. But we really want to reduce that stigma of releasing time is bad. And so, by making it very easy to do so, no one loses. The OR gains by knowing when a provider wants time or doesn’t need time. Makes it very easy for a provider to release time or request time. We often can see huge reductions in the waitlist. So we saw that at OhioHealth. They went from a number of physicians in the queue waiting for OR times. 


They knew they had cases too. The physicians knew they were going to get it. And then we’re saving blocks in the long run. Blocks are time, time is revenue for ORs. All right. So let’s move on to Collect. I didn’t show you a demo on Exchange of the view from the web-based tool, but just to highlight on that, if a provider– so we get this question a lot– if a provider does not want to release or request his or her own time, can their assistant do it? Yes. Do they have to do it on the mobile? No. They can easily do it on the web, and this is any web. So it doesn’t matter what computer you’re on, what device you’re on, this is all cloud-based software that is accessible to those that need it in your organizations. OK. 


So Collect. Collect is really our way of addressing the challenges that leadership teams have in how do we allocate time, who do we allocate block time to, when do we allocate them time. Block utilization, to be frank, is a poor metric to use when deciding when, who, and how to get block time to. We actually did another webinar just dedicated to why block utilization is not your best metric. If you really want to spend some time just talking about that, I encourage you to visit our website and find that webinar, or reach out to us at, and we can spend a lot of time on that. 


I’m going to do maybe a two-minute overview on that here just to touch on why block utilization is not the best management tool for block time, and why we really feel Collect is. So what is Collect? Collect is a different way to look at a three-dimensional view, really, of who’s using time well and/or when are there opportunities in an OR. Block utilization policies we find are often hard to enforce. They’re often not surgeon centric. They penalize surgeons for things that are often out of their control. Yes, maybe you had a delay in your first case, maybe you had long turnovers, so that set your utilization at 65%. Block utilization policy might say, let’s go after that physician and maybe try to reduce their time. Well, one minus 65%, what do I do with 35%? Can I take away 35% of the block owner’s time? Probably not. 


So that’s why we feel it’s not a very good metric to use when evaluating how to allocate time. So collectable time is a fair process. It’s more transparent, and it’s very simple. So what does that look like? Let’s look at two examples first, where we talk about really what collectable time is versus block utilization. So take these two examples of physicians. Surgeon A has block time every week– and I’m showing you roughly a quarter of block time– same with Surgeon B. Surgeon A, you can see cases are packed tighter, but this surgeon may be a sports medicine doctor, for example. More predictable case lengths. They can then pack their cases a bit better. 


But at the end of the day, every quarter, roughly 2 and 1/2 blocks go unused. For what reason? I’m not sure. Maybe it’s demand isn’t there with their patients. Maybe they’re always going to conferences, so they have a high demand to be present in an academic setting or in a leadership setting, and therefore, they can’t just meet every single week consistently for 13 weeks. Surgeon B, on the other hand, operates every week for 13 weeks. But the case lengths, we don’t know. We don’t know if today it can be a six-hour case or an eight-hour case. This might be an oncologist, someone doing unpredictable cases, where they do vary in length. But at the end of the day, they’re consistently using the OR, they’re there every week, and they need the time for their demand. 


Both of these surgeons, at the end of the day, have a utilization of 75%. Surgeon A, on one hand, though, we know that we can probably reallocate time to someone else or distribute that a different way. Surgeon B, not necessarily. So collectable time is a way to not look at all the little delays, and first case sometimes starts delays in turnover. It’s a way to look at three different things. It’s how we look at when were there large amounts of time that we’re not used. Take for example, 315. This entire day was allocated to this physician. We didn’t know that the time was not going to be used. It was not released, and there was no communication to the OR, but there were no cases scheduled. So that’s one aspect of what collectable time is, really identifying when that happens. 


A second aspect is, when are there large amounts of time on the table? And large amounts of time can be determined by each hospital. For one hospital, maybe a large amount of time is an hour. For another hospital, maybe a large amount of time is four hours. The point being the smallest unit of time in an OR is not a minute. The smallest unit of time in an OR is the smallest amount of time you need as an OR to do another case. So, again, collectable time is– part two is, when do people leave large amounts of time on the table? And part three is, when does a provider release too much time? And what is too much? Again, that’s a metric for a hospital to determine on their own. So I said I’ll keep it 2 minutes. I probably went a little over. 


But I would love to talk about collectable time even more. It’s an exciting metric to really roll out to hospitals. At the end of the day, what do we do? We give hospitals a very easy to use table with very sophisticated analytics in the background. That was just the elementary definition, if you will, of what collectable time is, but here’s the output. So for Alyssa’s group, even though they managed their block time pretty well, they had a process to implement this tool, took things to a new level for them. And she can talk more about that change. But it allowed this output in a table. OhioHealth was able to determine their own threshold. 


What’s a large amount of time for OhioHealth? They were able to put that in themselves through this Definitions tab. What’s an acceptable amount of release time? Right here, they were able to define that through their own table. They can change that for locations or for service lines. After they do that, making it simple, easy-to-read table, where’s my low-hanging fruit? Who should we have conversations about which block owners? What should we do about that? Take for example, Dr. Michael. If we allocate 27 blocks per quarter, and collectable time is suggesting we take away six, why should we take away six? Well, here’s that whole another level of detail. 


Getting down to the specific day of the block, why it was not used well to have meaningful conversations with providers, and to make actionable decisions with leadership committees, whether that’s a block committee, an OR committee, et cetera. So that’s Collect. We want to look at how do we free up more open time in the OR. How do we make block decisions easier? How do we accommodate new surgeon growth? That was something Alyssa touched on earlier. And, finally, there’s Analyze. So what makes Analyze special? 


I think today that the single source of truth is an issue for a lot of perioperative environments. Sometimes you are creating homegrown dashboards yourselves, using your EHRs to report out information. Occasionally, there are process improvement teams involved in really owning the analytics and performance metrics for a hospital. At the end of the day, there’s often a lot of hands in the pot doing a lot of different configurations on data and what is the source of truth. So if that’s something that touches home with you, then I think you’ll find. Analyze quite interesting. And this was an issue for OhioHealth in that they had different people running different reports for different reasons. So making one single source of truth to easily export reports on performance metrics is moving in the right direction to real-time analytics, putting analytics in the hands of everyone, making data transparent. 


Today, data is, in my opinion, not transparent in our perioperative environments. If you feel it is– and maybe that way that it’s transparent is to send emails, send attachments, or put it on communication boards– my guess is it’s not touching everyone or it’s not making it extremely easy for your CEO to get a five-second insight or your data analytics individual to pull out multiple reports in a short period of time. So increasing that credibility, the transparency is critical for all of our periop environments. So Analyze is available for our customers on mobile or on web. Physicians get a weekly text message to say, hey, here’s what we saw, here was your utilization last week, here’s how many cases you did. This was something. OhioHealth they wanted, this community-based system. They have non-employed physicians. They have some employed physicians. 


Either way, they wanted to push information and make it really easy for all their providers and their offices to have access to what are they even contributing towards the OhioHealth as far as volume and metrics and efficiencies. Physicians often come into offices and say, my first case on-time starts are terrible because of a, b, and c. Well, let’s put the data in their hands so they have the facts first before coming in, so we can have those insightful conversations. So they get a text message every week. In that text message, there’s actually a link right here. Again, cloud-based, so nobody has to download anything. A simple link that launches a mobile browser and gives you a ton of information at your fingertips. This information can be from an administrative view or provider view. 


Right here, we’re showing you a provider view. Shows you the day of the week, when your cases were in the OR, where you’re ranking among your peers, how the time was spent, did you do a lot of cases outside of block time, within block time , were they minutes that were business hour minutes or after business hour minutes, what would [INAUDIBLE] looking like, what was the turnover like, what were the first case on-time starts, what were the reasons for the delay. So all this information lives in your EHRs, and we want to extract it, make it easy to interpret, and put it in the hands of the users. 


You’ll notice at the top of the screen, it says “Week of.” You can easily toggle back and forth between weeks or months. You can look at utilization. You can look at volume, delays, and you can look at available blocks. So, in a nutshell, those are the three tools that we really helped OhioHealth implement. And I would love to hand it back to Alyssa to talk about that change management process. 


ALYSSA TROCCHIO: Thanks, Ashley. So Ashley walked you a little bit through the innovative technology that we adopted at. OhioHealth, but I’m going to talk a little bit about how we engage the people in implementing the process before, during, and after. So, as I mentioned, we really did need to engage the right people before, during, and after the implementation process. So I, as the project champion, really needed to do a lot of heavy lifting on the front and during, but not as much after as the process became much more automated through Exchange,. Collect, and Analyze. 


Those tools were now available to me, and I can just go and use them. Where before the process was implemented, I spent a lot of time, as a lot of you on the phone would know, going through the approval processes at OhioHealth to help everybody understand the value. As the product, iQueue, has tremendous value, it wasn’t very hard to sell. But on the screen here, you’ll see the red, green, and yellow, and I’m going to walk you through what that means. And I mentioned my time commitment. That’s what we’re going through in trying to illustrate how everyone was involved. So for the executive leadership, on the front end, we really had to share with them what is Collect , what is Analyze, what benefit are we going to see from this in the long term. 


And at OhioHealth, we had a lot of different IT committees and hurdles that we had to get through to help them better understand. And LeanTaas really partnered with us side by side to help us get through that process. And I’m going to invite Ashley to join the conversation because she was also with me on this journey of trying to engage the right people. 


ASHLEY WALSH: Yeah. I think it’s critical that– especially the role that Alyssa had was so instrumental in getting this up and running in the first place– bringing the right people to the table to have the right conversations to push this through as fast as possible. I’m sure many people on the phone feel the same, which is having anything new takes time or implementing anything new takes time. We’ve done this rodeo a few times. Alyssa has been a part of the OR for many, many years. 


So getting the right person to engage all these individuals from the beginning makes this such a seamless process, which is awesome. You can see through the diagram the amount of commitment, especially that Alyssa as project champion had before and during. But now, in this after stage, OhioHealth is becoming so self-sufficient. The automation is tremendous to using the tools, not needing as much people but more process. So I think that’s been a very exciting journey to watch them go through. 


ALYSSA TROCCHIO: And as Ashley mentioned, you see the dark circles there in the left hand side for Before, we really needed to engage our surgeons upfront, and they were an easy sell. Once they saw the benefit this gives them– the insight, the transparency, and the metrics– that’s something they didn’t have before. And a lot of them were craving. They wanted to understand. They would get utilization reports maybe quarterly, if that, because, as Ashley mentioned, our data analysts spent at least 30 hours preparing reports just for us to review, let alone to get surgeons their specific metrics. 


Some of them probably didn’t even know where they were at, unless we had to have a conversation with them. Now they’re getting those weekly texts, and that makes those conversations much easier. They also really liked the concepts that they were going to be able to request in half time when it was available to them. Collect allowed us to– we took one of our groups, our group surgeon blocks, and we switched them to individual time. And we also paired back a little bit of time and made that open. And that was an easy sell because we had the data available for them to see where they were leaving open empty blocks on the table. 


ASHLEY WALSH: And what we’ve seen on the back end now, since they’ve done that, is the accountability goes up 10x, from transitioning from a group block to provider blocks. And truly, the providers are individually using it anyways. And that was a good group to do that in. Can that be done in every service line? No. There’s definitely still a need for a service line time or trauma time or whatever other open time that you have in your organizations. 


But in Alyssa’s example of the physicians that they drove towards a physician-driven time, they were already doing that. They were already operating, my day is Monday, your day is Tuesday. And now to see the accountability increase through the ease of use of the tools, they’re releasing time. They’re giving time back to the OR, and more providers are getting that time. Alyssa, didn’t you mention earlier that of all the increased block requests, over 50% of those requests came from providers that never even had time themselves? 


ALYSSA TROCCHIO: Yes. We did see that. One of the things. I want to touch on is there is some red on this slide because we wanted to be transparent that this wasn’t always an easy process. We did have some challenges. In particular, upfront trying to articulate the value to IT and how that this is really not a heavy lift on their part, and that this is going to give us tremendous access to reports that we don’t have today. Our EHR is great because we have a ton of information, but we can’t necessarily optimize that or make it actionable. And so, we didn’t have a challenge going through those approval processes and trying to explain the value that we had, but you can obviously see that that changed to green, and there has been low impact to the [INAUDIBLE] department in specific– in particular, over time. 


For our surgeons, we did have a little bit of a delay on the front end with the approval process. And so, we had to make sure we kept them engaged all along and shared with them every time we got a new update. And every time, the implementation process went so smoothly after the approval that I had to figure out how to manage up the message that we were doing this and it was happening. There was such involvement from the OR schedulers and the clinic schedulers. I was getting emails regularly about how great this was for them, how easy the release and request process was, that it just started happening on its own. It was very automated, and so I had to make sure I had the right tools to manage the message to those who were really impacted daily. 


It was so easy that they never heard from their schedulers. The surgeons were never calling my vice-president and saying, hey, I can’t get this block time I need, because now it was available to them. And I think that piece is important to touch on. And not only was everything green and went really smoothly. We did work through a lot of challenges, but LeanTaas was right there with us making sure that we had the tools. And they would come to on-site if they needed to, and they were really available to us at any point. 


ASHLEY WALSH: That’s awesome. We noticed that too. So before the implementation, we needed that support from surgeons, IT leadership, and you as a champion. Everyone’s involved but in different capacities. So during the implementation process was when we first really got to talk to your schedulers, talk to the physician’s schedulers. And let’s be totally transparent in this. At first, everyone’s like, “What? Am I going to do something different?” And that’s probably a little bit more why we even indicated level yellow there because it is introducing a new step for them, a new way to do things. 


I have yet to have one conversation, though, with a scheduler after an implementation, where a scheduler was not happy about the streamlined process of requests going into one repository, released into one repository, the ability for leadership to monitor, the statistics of those requests and releases, those transactions of time through the Analyze tool. So it is managing change, and it is managing up. And so, getting everyone involved from the beginning, really having everyone stay closely involved during the implementation, makes this such an automated process after that it just becomes a part of everyone’s workflow, every day. And truth be told, all schedulers were doing all these things, probably 10 times more cumbersome. So then we have allowed them to do it today. 


ALYSSA TROCCHIO: I would absolutely agree with that. And with that, I’m going to tell you a little bit about what we did in the process aspect. We really needed– and Ashley touched on some of that, but I’m going to go into a little bit more detail about how we actually did it. We really needed to make sure everybody was committed to a single source of truth, and that includes– and I think the biggest part is for the OR schedulers and the clinic schedulers. 


This really does change their process. And so, we spent a lot of time making sure we rolled it out in the right way, and we gave them the support that they needed. And so, the way we did that is, at OhioHealth, we had a really close connection with our clinic schedulers. And we invited them on-site twice a year to give them updates about pre-admissions testing, pre-op orders, the OR scheduling, anything that we needed to inform them about. And so, we brought all those schedulers on-site, or we would go out to them if we needed to, and we would give them demos, and we would show them how to use it. And it was pretty self-sufficient after that. It wasn’t like I had to implement this 10 times over. It was one-time and they were using it. 


They were releasing and requesting time. What really proved this to us is our director came up with a contest to have the clinic schedulers, when they came on-site and we rolled it out, he said let’s offer them gift cards to release time. We know that they’re hanging on to low-hanging fruit, as Ashley mentioned, where their surgeon, Dr. Trocchio is going on vacation in. April, July and August. And so, when they came on-site, we said, we’ll give you a gift card if you release all the time that you know your surgeons are going to be here. And if you release the farthest time in the future, we’ll give you a gift card. And that day, we went back at the end of that– it was a Wednesday– we had 50 blocks released. And I can’t tell you what that equates to, but– 


ASHLEY WALSH: So exciting. 


ALYSSA TROCCHIO: That’s how we knew that we had capacity that we can create, and that’s that almost low-hanging fruit, where we didn’t have to take time away. We just needed surgeons to release their time that they knew they weren’t going to have. And on top of that, we can then have surgeons who don’t have block time go and request that release capacity that was created. 


ASHLEY WALSH: It’s exciting, especially in a community environment where you probably have physicians that split time among various hospitals in the region. So to allow them that insight as to when they can bring more volume to you, or when they’re not going to use time that they had allocated, is powerful for you as a leadership group. 


ALYSSA TROCCHIO: Yeah. And as I mentioned, so we really needed to get everybody committed. We had to train them. We rolled it out. We provided the appropriate support. And that last piece is what. Ashley touched on a little bit early on. We had to figure out how we report and celebrate successes. And at the end of the presentation, we’ll show you just very quickly, we created a one-page document, an executive summary, that really helped me manage up to the director, vice-president, our leadership team at Riverside, that says how we’re doing, what’s the ROI, basically, what’s the return on the investment that we’re getting, and what’s the satisfaction, what are we seeing overall. 


And so, this tool was really helpful to help me report success instead of just doing it during my one-on-one, and it went in and out because there’s so many things going on. This is really– it seems simple, but it was really helpful in helping us report and deliver that message. And, again, I think we just, on this side, repeat the tremendous success that we’ve seen over time. We’ve seen over 500 blocks released in the last six months, 300 blocks requested. Blocks and/or cases, for that matter. You can also request small incremental amounts of time. 


Our lead time has gone from three or four days, maybe seven days, to over 22 days in advance. So they’re now releasing time over 22 days in advance, and that is much more actionable for us than it would be if it auto-releases at seven days. Over 50% of the surgeons who don’t have group or individual block are requesting time through the tool. And, as I mentioned earlier, we reduced our queue of waiting patients to have surgery from 30 at seven days out to three patients a week. 


ASHLEY WALSH: Awesome. Thanks, Alyssa, so much for all of that. Again, please, please email us at, or send us a text if you want, 630-884-5493. I see a few questions coming through. So one question was, how do you get physicians or block owners to release time? So, Alyssa, what was your experience pre-rollout of Exchange for physicians releasing time? Did you have good stewards of the OR? Not-so-great stewards? 


ALYSSA TROCCHIO: We had a little bit of both. I think what you’ve seen, if you go to that slide where the amount of release time, what you can tell is that it was just a very manual process. I even had a conversation with one of the schedulers from the offices today– still, even after my role at OhioHealth– about how she forgets to release time. She sent us an email that said, I’m going to book into this time– she received one of our release reminders– she said, I’m going to book into this time, I just wanted to let you know. And I said, thanks for giving us the heads up. 


You don’t have to let us know, but we just want to make sure you’re reminded. And she said, good, because I’ll forget. And that’s what I think we saw over time is it was not that intent on anyone’s part. It was a cumbersome process for the surgeons or the office to remember to do it, and so, oftentimes, it just went undone. 


ASHLEY WALSH: From a data perspective, what I can tell you in looking at your data is, one thing that we do through Exchange is we’re pushing out release reminders. That’s a part of the. Exchange process. So when we see that block owners typically have cases booked on the schedule at least 14 days in advance, 13 days in advance or even 15 days in advance, we push reminders to them to say, hey, we see no cases booked in your block. Could you consider releasing it or transferring it? If one of your colleagues is going to use it, fine. 


Exchange allows for that transfer. The releases that we saw increase for you after we rolled out the release reminders was huge. So just pushing them that reminder, like your dentist office does. Are going to come on. Friday for your cleaning? Yes or no? Makes it really easy for block owners to say, you know, actually, I’m going to be out of town, so I can release this time and the OR can use it. I see another question around scheduling. The question is, do physicians schedule their cases directly into Exchange? The answer to that is no. And that’s very intentful. 


So we want your EHR to be your source of truth. It will always be your source of truth. iQueue sits on top of your EHR, so we extract data from your EHR, either real-time or daily, to expose available time to your providers. Just like OpenTable would, we allow them to see, can they do more cases. And all that we are allowing them to do then is request a reservation. At the end of the day, you still need that human intervention in ORs to say yes or no. I feel that that’s very critical after managing an OR myself and knowing that you don’t have enough equipment to run three alarm cases simultaneously. We don’t have three alarms. Or I only have one hybrid room, so I can not allow two physicians in there at once. 


You still need that last half a mile to have human intervention of yes or no. So iQueue Exchange is a way to reserve open time to make it transparent to all of your providers in the community, and to release time that they’re not going to use. And now with the other question, how do we get the data? I touched on that. Many different ways, we can set up a real-time feed with your EHR so that we are seeing when time is available on your schedule real-time. We also can do it through a simple daily job, where we extract data daily that goes to our server, lives in our server to say when time is available, and then we expose it to your providers. Depending on which route we go with a customer depends on then the workflow we will implement. 


For example, if we are a daily fee job with your organization, we would want to set up restrictions on when you would grid cases or when you would not grid cases, or how long in advance can we show time available depending on your workflow of when you close your OR schedules and make time unavailable, or make it only available for the OR to then determine how many rooms are running, what cases go in what rooms. So we always are going to work with what fits your day-to-day workflow. I really appreciate everyone’s time. I don’t see any more questions coming through. Marianne, did you see any additional questions? 


MARIANNE BISKUP: I see one more question. And also, I want to remind people, you can use the Q&A feature. The right hand corner of your screen, if you have any questions you have yet to ask. It looks like we have one more question. Would you think your experiences in OhioHealth can be applied well to other community hospitals or academic hospitals? 


ALYSSA TROCCHIO: I think both. I know where Ashley came from, at UC Health. They have an academic institution, I believe, in multiple community settings, and it works very well for them. I think these challenges are seen across ORs across the country. It doesn’t matter whether you’re in an academic setting or community setting. The lack of visibility into operating time, the collectable time or time that goes unused, those are all issues that everyone is seeing. And so, the tools created by LeanTaas, and iQueue in particular, are something that really can help prepare you for the challenges in the future. So I don’t think that the setting per se makes a big difference. 


MARIANNE BISKUP: We just have another question that came through. Is iQueue a system you have to purchase or a tool you can use? 


ASHLEY WALSH: It is software that’s available for purchase. It’s also a la carte. So if your organization is in need of specifically the transparency into the schedule, the ease of requesting available time and releasing time, you can contract for just Exchange. If you have no reporting repository today, if it’s very challenging for you to extract any data, you can also just purchase Analyze. We do not confuse customers for hostages. So if there is one aspect that is in need for you at your organization, we would love the opportunity to work with you and to implement that specific need or use case in your organization. So I would love to hear more from you. The individual that asked that question, please send us an email or text, and we’ll be happy to get in touch. 


MARIANNE BISKUP: OK. Well, I don’t see any more questions coming through. I want to thank. Ashley and Alyssa for doing the webinar today. Stellar job, as usual. And thanks to all of you for joining us today. Friendly reminder, keep an eye on your inbox. We’ll be sending out a link to our recording of the session later today. Also, you will see a short survey pop up at the conclusion of this webinar. 


Believe me, I know surveys are annoying, but they do help us fine-tune our contents so that we can continue to provide relevant information for you. It’ll only take a few seconds. And, again, even though we’re concluding our webinar today, we’d still love to keep the engagement moving. So if you have any questions, any concerns, you just want to contact us, you can email us at, or you can text us at 630-884-5493. Thanks again for joining us. Have a great day everyone.

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