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Webinar Transcript: Why OR block utilization is the wrong way to look at surgeon usage

This transcribed webinar, featuring LeanTaaS Director of Client Services Ashley Walsh, and OR Group Product Manager Zetong Li, discusses a more comprehensive way to look at OR block utilization with the concept of “Collectable Time”, and also how to communicate such information with surgeons effectively. The session is available on-demand here.

Moderator: I’d like to introduce our presenters. Today we have Ashley Walsh, who is our Director of Client Services. We also have the Zetong Li, who is the group product manager for OR. So let’s go ahead and get started.

Walsh: Thank you joining us, we are so excited that you all could attend this webinar. Today we’re going to be talking about why surgical block utilization is not your best metric and why we feel that is the case. To go through a little bit of an agenda for the day, we’re going to talk about the OR and why it’s so important, really why the OR is the economic backbone of your hospital. Then we’ll go into detail on why we feel strongly that block utilization is not the best metric to use when reviewing and analyzing the efficiency of how blocks are used in ORs. 

Today we’re going to share with you a very exciting term. It’s a proprietary term that we’ve talked created through their own algorithms, which is Collectable Time. We’re going to share with you how Collectable Time is a different way to look at how hours and blocks are used in our kind of reiterate everything at the end. Revisit why the opportunity is so large. And then there’s plenty of time for Q&A.  We would love to hear from you, and continue more conversations with you offline. You can send us an email at 

Let’s jump into it. It’s no secret that the OR really is the economic backbone of all of our hospitals. When you look at all the hospitals across our country today, roughly 60% of our hospitals’ revenue is coming from the production in the perioperative or OR space. That’s a lot of revenue. And it’s a passion of mine that we monitor the efficiencies of our operating room and figure out how can we improve the efficiency of our operating room, which ultimately improves the bottom line for our hospitals, with each of our minutes being worth roughly $100 to $300 per minute.

And that’s just OR time. So we’re not taking into consideration revenue from pharmacy, labs, inpatient stay, expensive implants, expensive surgical supplies. We just talked about the time billed from the OR when doing a survey across the country. We see that that falls somewhere in the $100 to $300 per minute for OR when you look at an average business day. What is that worth? That’s worth roughly $50,000 in revenue to $150,000 in gross revenue, just for the time per hour per day. So if you were to improve your utilization even one percentage point, just one percentage point, you could be looking at increasing your revenues $1,000 roughly per hour, per year. So you look at an average hospital with 20 hours just improving your utilization three percentage points, you’re talking about millions of dollars per year. 

Do you see why I get excited about this, why we’re very passionate about this, and that there are better ways that we can look at improving the efficiencies of the hour? So on the right side of your screen, you’ll see a case study that we recently published alongside UCHealth. As was mentioned, I previously worked with the preoperative business manager of the University of Colorado Hospital, which is an academic Medical Center in Denver, Colorado. It’s a part of a large system in Colorado. UCHealth is comprised of seven hospitals. My hospital is the only academic one the rest of the system is community based hospitals. They published a case study discussing how in implementing a suite of tools and utilizing this concept of collective time and looking at things differently, not necessarily using block utilization as we historically have, to monitor the efficiencies of the OR led to very significant improvements in this hospital. 

So we saw that blocks were really 47% more releases for OR block. And why is a released block important? Because then we can reallocate it if we know our physicians are not going to use their blocks ahead of time. We can adjust our staffing. We can reallocate our blocks to other providers. We can be more efficient with our time. UCHealth saw that 10% more blocks were released earlier. So being released 30 days in advance instead of 20 days in advance. So that was better at the end of it all if they saw a huge increase just in their block utilization. And so for their suite of over 25 hours that led to over $400,000 per hour in revenue per year increase. So that was really exciting. 

If you’re interested in hearing more about that case study, again, please send us an email. You can contact me directly at LeanTaaS, and we would love to share that with you in more detail offline. Now, how we evaluate the efficiencies in our hours today. On your screen, you’ll see a lot of terms that you’re very familiar with. First case on time starts. These are important key metrics to analyze in our operating rooms. First case on time starts, turnover delays over room utilization and OR block utilization. For me previously, in my eight years as a perioperative manager, these were my primary key performance indicators that I focused on. Today our focus will center on block utilization. OR block utilization is probably one of the most challenging ones to monitor, analyze, and effectively change in my tenure of being a business manager. I’d love to share with you some thoughts on why we feel block utilization is not your best metric. 

Let’s talk more about OR block utilization specifically. This is one of the many ways to define how you calculate OR block utilization. I think this is a very standard definition, that block utilization typically is your time in the room. So patient wheels in, two wheels out, frequently we include turnover in that calculation, whether it’s your scheduled turnover area or actual turnover is where you’ll see variations in this calculation across hospitals. And we do that divided by the total allocated minutes per block five or many minutes you’re allocating per block owner per day to get block utilization. And so when you do all that, you get a magical percentage. And that is a standard definition for block utilization. 

What’s wrong with that? Let’s take a look at two examples here in the left hand, showing you an example of just for example’s sake, we’re going to call an orthopedic surgeon and each row represents a different day that that surgeon in that group may have had. In block on the right, for example sake, we’re going to look at a neurosurgeon and how their days may have looked in their blocks. Both of these examples yield a block utilization of 75%. But they look very different when you look at the example on the left, you can see that the blocks were pretty tightly packed turnovers might have been delayed here or there. There might have been a delay in first case on time start here or there, but overall pretty well packed. However, they didn’t use all the blocks that were allocated to them. 

So we can see at the end of the day, there were about 2.5 days of block that could have been reallocated to another block owner. Now in the right hand side, it’s a very different example. We’re using this example of a neurosurgeon whose cases vary in length. Sometimes they’re three hours sometimes, they’re four hours, sometimes they’re seven hours and you can see that there really wasn’t any. Even if you tightly packed them a little bit better. And the turnovers were a little tighter at the end of the day. Could you really put on another case. Maybe yes but probably no so this is an example why two different service lines have very different yields with the same percentage. So when you compare block utilization across service lines. It’s not very actionable. 

One line is block utilization really means nothing. Typically block committees meet monthly and they look at a list of block owners and they have a threshold. I’m sure that this is very familiar for many of you on this call today, that your threshold may be 60%-70%, if you going to start looking at who is below that percentage point. And then you’re going to try to figure out can we take away block time can we reallocate block time. But just as in the example before 60% for one surgeon is there is very different for 60% for another surgeon. And then you have to do more investigating as a committee to determine why. Could maybe I take away some time from this 60% equalizer and not the other. And it’s in that example before where there’s so many variations. So what else does that mean? It means it’s not surgeon-centric. It’s not being surgeon-friendly. We’re penalizing surgeons for many things that are one sometimes out of their control and two sometimes not actionable. 

So we can’t compare block utilization across service lines without doing further investigation. It’s not comprehensive. So when you look at the inverse of block utilization they’re being penalized for those turnovers. They’re being punished for when they’re longer than the scheduled turnover, they’re being penalized for delays in first place and time starts. If you’re a surgeon who’s bought time that’s supposed to start at noon and the previous surgeon went late, you may or may not be penalized if you’re started late and if you are penalized, then there’s going to be broken aspects of your calculation for other black owners meaning the morning person who starts late might not be highlighted for starting late. 

So it’s just a very broken metric that, in a nutshell, is not comprehensive at all. And so that’s what makes it so challenging for us as administrators to enforce, just from my own experience, block utilization with one metric. I had to run another different report to look at 10 other different metrics to understand if I really could act upon that low block utilization and reallocate it to someone else. So I think you hear what I’m saying, which is it’s a very challenging metric to enforce and therefore, it is a want to turn it over to my colleague return right now. Who’s going to share with you a little bit about a new term a new way to look at how well blocks are used in the operating room. And it’s a proprietary term from LeanTaaS, known as Collectable Time, which I’ll pass over to Zetong to explain. 

Li: As Ashley has just mentioned, she used to run multiple reports to get to the real understanding of block usage. And I realize that’s like the intention of block utilization as a metric is to help administrators and surgeon committees to make decisions. However, like block time utilization itself, it’s not actionable with its intention. As we work together and try to figure something out that can help people in the way that they just need to look at one number or maybe one number or two or two to one table. And from there, they likely will be able to see the big picture and make a decision that people can believe in. And that’s how we got to Collectable Time. I’ll play a short video to explain what it is. Let’s start from there. 

With block utilization, the traditional way to track OR performance is not always actionable and can unfairly penalize surgeons. The way it’s calculated and reported total in block minutes plus turnover divided by allocated minutes minus release minutes isn’t really actionable. Let’s take an example. The green boxes here represent utilize time, the gray boxes represent unused time, the white boxes represent releasable blocks. Today we count all gray boxes as unused block time. That’s the problem. Let’s take a closer look. Look at these periods of unused time. They’re so small. Maybe the surgeon finished early or maybe things just got delayed a bit. Even if we reclaim them, we can’t schedule any cases in them. 

Now let’s take a look at real time. On one hand, it’s not fair to hold surgeons accountable for all of their released time. Sometimes things come up, vacations, conferences, clinic schedules, and other conflicts that make it perfectly reasonable for a surgeon to release their blocks. On the other hand, if a surgeon consistently releases a majority of their blocks to block utilization. The way it’s calculated today can still be high. There is a better way to go about this. We call it Collectable Time. In a nutshell Collectable Time is any unused time that can realistically be reclaimed. It’s a much better way to track utilization because it’s actionable it’s realistic and it’s fair to surgeons. 

Going back to our example, the red boxes here. That’s Collectable Time. Why? Because we can actually reclaim them and put cases in them. We can’t put cases in these smaller blue boxes. So we ignore them. We can set realistic thresholds for what’s to good reclaim in the period of time. And what’s not for hours, for example fairly conservative. It means that any unused period that’s less than four hours will be ignored. And anything that’s longer than four hours will be considered as Collectable Time. We also can set an expectation for relief to time. For example, we can say releasing up to 30% of allocated time is acceptable that means if a surgeon has 10 blocks will say releasing three blocks is acceptable. And if you release more than three will consider that as Collectable Time. 

Now let’s see the numbers in this scenario, we’re looking at 12 week example. 12 blocks allocated, four of them released, eight of them kept unreleased. Now adding up the green areas the surgeon used 3,4 blocks worth of time. Block utilization as currently calculated would be 43 percent. Now, can we take away 57% of their block off. Now let’s look at collectable blocks. This is unused time, longer than 4 hours and release time over the acceptable threshold. So it counts as Collectable Time. This is unused time shorter than four hours. So we simply ignore it. Using this logic the Collectable Time equals roughly 3.4 blocks or 29 percent of the total allocation. Now we can say, let’s take away one block every four weeks. And this is fair and considerate because it wouldn’t affect the search engine in any way. 

We’re only taking away time they otherwise wouldn’t have used, based on their demand for patterns collectable time is a far more comprehensive actionable and fair metric to better manage block allocation. That was just a simplified example. The iQueue block supply table looks at the big picture. It continuously looks at the past 12 weeks and past 48 weeks and makes recommendations on collectable time. And it’s fairly conservative all right. Hopefully that’s some like something making sense to you. I’ll just go over this once more. So in this visualization, we are seeing a very similar example with what you are just seeing the video. 

Each bar indicates a day like off the block. Some surgeon might be happy allocated from area surge all the way to the March 22nd,, which is very typical allocation periods that we could look at if we were it like at April or May block meeting saying, let’s look at this. And as a surgeon committee we’re seeing that some cases are being done in the blocks and the blue bars means the used time, the green bars means the unused time. There are four released blocks in this case. And you can see this blue triangle, these are what we call Collectable Time, because they’re so small. Take the January serve for example, maybe it’s four hours 7:30 to 9:30, 7:30 to 8:30, is just what our two hour chunk that’s it’s difficult give to someone else to real estate they put a case in there and something similar would be towards the end of day, January 24, maybe it’s like ending the case about 3PM, 4PM, while 2 are left and people cannot really do anything about it’s more cases like on February 1. 

There are small chunks off 30 minutes, an hour in between cases, then as you see the red diamonds, these are the periods as we call clock to a time that we should not ignore and we should consider in the cut of all time magic. And we should also be aware that’s leadership or the certain committee themselves will be able to decide how much time is acceptable. It is acceptable to lease. So the entire model is very customizable, meaning you can decide how long is too long for a period of only use time. And you can decide how much is too much in terms of releasing time. 

So here’s like how it looks in our iQueue products, meaning you can choose all the way to 100% release. Release time is okay, meaning that even if someone releases all the time, we don’t count it as a bad behavior, which is very lenient on the other hand, you can lower this bar you stay maybe 15% is a good measure, which is about how much time typical American corporations get people on the PTO or something like that. And similarly, like you can say maybe four hours is too long to leave open. And then they can shrink it to maybe two hours or shorter. This could be very useful for like hospitals with different kinds of surgery centers, if it’s an academic center most of cases are long, and you want to consider four hours or three hours. That’s like long enough to fit a case. And if you are from commute b likely from a community environment La or a two hour might be enough for you to make a case there. 

And so this is what I meant by making it comprehensive and straightforward for the decision makers to use. So instead of showing you OR utilization and leave the user or the administrator to figure out whether or not you should take away blocks, we have to consider all of these like delicate details and say for this block owner, for this day off, this week in this location, the block time is 20% And that means that you should take how much block, out of how much block, and for another block owner with another block collectible percentage, you should take away another number of collectable blocks, versus allocate a block and once you look into the detail of each block owner, you will be able to see the explanation are the additives that builds up to the claim. So if you see that on the table. 

You can take away one block out of four blocks, then you can see how does that one block come from, he used it and another portion of them, is from how much time is released that too much over the threshold an hour. So you can see how much time is, really a how much time is not utilized during the day, that they have some cases, very similar to this interaction, you will be able to see how many minutes they were allocated and how much time they were using. And so the deeper you go, you can see how their day went, and what what’s the utilization by time of day. 

So it just gives you a comprehensive picture where you want to make a decision. and it gives you the full details before you to back up your arguments, which is what we were trying to solve with block utilization as a metric and again, for more information, you can email us directly.

Walsh: Thanks. Before we summarize, I’d like to back up two slides just to touch again on the Collectable table.I feel that there are a lot of people on the call kind of wondering about how we do that. How do we get this information? How do we calculate this data? I’ll let you know that LeanTaaS, the company, has worked with many EHRs already, Epic, Cerner, Meditech, McKesson. This information all comes from your timestamp data. It’s data that already exists today in your EHRs and it’s obtained through daily or weekly extracts. And then the output is in this very easy to understand user interface. So as far as time-to-usage, it can be quite quick, because they have that experience. 

We’ve had experience with all these different EHRs, we understand the ins and outs of all the different EHRS, and understand really what tables we need, what data points we need in order to turn this around very rapidly to users. So we have had customers that have gone live in four weeks, we’ve had customers that have gone live in six. So you can see that the time to value is very short. For getting this great comprehensive tool, I also want to highlight in this tool on the table. The Collectable table. that the inverse of OR block utilization is not the Collectable Time, that we talked about that a little bit what Collectable Time is. I want to highlight it a bit more, the block utilization is shows when OR physicians and block owners are in the rooms, including your turnover. And then Wednesday night in a room with some Collectable Time, just using one metric we’re really seeing all these different variables. When were they abandoned in time when were they releasing a lot of time when were they leaving large amounts of time unused. 

So not just the little back to that more surgery example, the delay in the turnover. But when are they leaving for hours on the table. That is a very significant amount of time like on the left under orthopedics. When did they leave these large amounts of time on the table that really could be repurposed. So it’s a very concise comprehensive surgeon centric metrics to use. So that you as a leadership team can know what best to put your eggs in which conversations do you want to focus on as a leadership team with your block owners so that you can make strategic decisions on perhaps closing down hours perhaps you know delaying the bill of other hours or perhaps using it as a recruitment tool so that you can bring more physicians into your hospital and know that you are going to have time available in your operating rooms. All right. 

So just to review again block utilization we know today is not a good metric to use. It’s a broken metric. That’s not comprehensive. It’s not surgeon centric. It doesn’t take into consideration all these different things collectable time is actionable. It is fair and it is serving a trick. So as a whole when you decrease your collectible time you are going to add an inverse increase your box utilization increase your room utilization and increase the efficiency of your oh, what are you. Pause for a second. I believe a question came through. So just give me one seconds.

The question is around how we integrate schedule time. So the surgeons that schedule cases for an entire block however they’re not efficient and either cancel or only perform half the day. Do we distinguish the difference. In fact or both scheduled and performed activity to provide a fair and comprehensive activity analysis. That’s a great question. The short answer is yes. We look at when does this happen frequently happen infrequently and was it because of scheduling or was it downtime. So I think I’ll be able to further answer that question on one of our upcoming slides. 

So let’s jump to the next slide. I want to show one more example of Collectable Time versus block utilization and then we’ll get back to that question about kind of incorporating schedule time. So in the last year, you see a block owner and again, as to Zetong’s example, the dark blue indicates some patients were in the room. And if we were to add up and calculate the block utilization for this block owner for this quarter, we’re looking at basically January 3 to March 8th, utilization would be 39 percent. So as a Business Manager Perioperative Director VP that would tell me that if the block owner had 10 blocks is suggesting to me, they’re only using about 40%, so maybe I should reallocate six blocks. 

You and I both know that that’s very hard to do. And that’s likely not attainable nor should it be necessarily in this case. On the right, let’s look at that same example and let’s understand what Collectable Time would tell me, if I were to put all of this information into the algorithm for Collectable Time, what would come out to me is that approximately four blocks out of 10 are likely collectable. And when you look at that, you can see that that provider a released a lot of time and left large amounts of time, those rare diamonds, unused or out of 10, that’s more surgeon- centric, that is more reasonable, and that’s more likely more accurate. That physician or block owner probably feels that they know they’re not using all their time. But if you were to walk in and say, hey, I’m going to take my 2/3. That’s a tough thing to solve for them. 

But if you walk in and say, we need to talk about this and have a conversation. I have this data that shows all the times you release, you leave large amounts of time on the table and the times that you just don’t leave your block at all, the conversation is likely to go smoother, alright. So let’s talk about why this is so important. And again, why the opportunity is so large. We’ve talked about the dollars you know the dollars are high. Our hours again, are yielding 60% of our hospitals revenue. So let’s use that time and space as efficiently as we can to not only make the best use of everyone’s time, our patients, our physicians, our staff, but also yield the highest dollar we can. 

So when we look at unused time in an operating room, we can go to the question of schedule time, and what role that plays. We can look at that. So we have looked at a number of different hospitals. And if you notice there, that statement of more than 53% of time under-utilized is collectable. What is that saying? So we’ve looked at hospitals’ unused time. And we’ve done this at more than one hospital. And when we looked at all the time that was unused in a block. It can be broken down into different buckets. It can be broken down into places just weren’t scheduled. You can see them on the last scheduled downtime. It can be broken down into cancer cases in general. That’s a much smaller number. That’s a much smaller number than even the perception in our hours. 

In addition, you can break that down into how much unused time is attributed to delays in our first cases. That’s an even smaller number case ended early for us. Back to the example of the question that was asked. We have done this analysis. And in this analysis we’ve seen that only about 14% of unused time is because of scheduling inaccuracies that type time study can be repeated at many at any hospital. I am confident we’re going to see a similar number, because we’ve done this at so many hospitals already and seen similar patterns of behavior, that about 14% of unused time off because of scheduling and accuracy over scheduling for case. About 11% of unused time has been attributed to delays from turnover or delays from first dates on time staff. That’s actually a pretty small number. And I know many of you on the call have participated in many events, that I have as well. 

Rapid improvements to improve our first case sometimes starts in turnover. I am by no means saying that those are not important metrics to pay attention to and monitor. They are because improving those metrics improve our team communication improve our patient access. We should be monitoring our first case on time staffing turnover. However, even if you shave off a few minutes here or there at the end of the day, you’re likely to not put another case on. So what we’re saying in this is pay attention to those metrics or efficiencies or communication as a team patient access. But if you want to get more bang for your buck in your OR, that’s probably not where you’re going to get it. You’re probably likely to get more bang for your buck by focusing on the scheduled downtime. 

And so again, looking at all of this together and decreasing that Collectable Time, the scheduled downtime is collectable and that’s what we’re telling you here. We want to help you identify what is applicable in your eyes and how can you repurpose that. How can you use that to increase your efficiency because again decreasing that Collectable Time will increase your utilization so I hope that that was very useful to you.

We would love to hear your questions right now if you have some. Again, we would love to continue this conversation. So please email to continue that conversation with us to ask more questions, if you want to hear more about the case study, want to know more about how can you get a Collectable Time table in your institution. 

We’ve had this question in other webinars. How do we get our physicians buy-in? And I’ll tell you, it’s increasing that transparency, increasing the communication, and the recording with our providers, getting data in their hands on their mobile devices. Weekly, daily. Having them understand these metrics. So that conversations don’t come as a surprise to them or that you’re not expecting them to open up an attachment an email once a month. So increasing those transparency and efficiencies in reporting can help also increase all of the overall efficiency. 

So again, I thank you so much for joining us. I’d love to turn it over to questions.

Moderator: Thank you very much Ashley and Zetong for presenting a wonderful webinar today. Believe it or not, we already have questions percolating. 

So the first one. How far in advance do most hospitals set as a time when the hospital can collect unused/Collectable Time? 

Walsh: So I believe that question may be pertaining more to releases, when the automatic releases are. So Collectable Time is truly looking at unused time in the OR. So it’s looking retro when was time unused in the OR was it because there were 4 hours unused here or there, was it because a whole day was unused, or was it because they released more than their threshold? Releases are definitely up to the hospital, if it helps to answer the question of how far in advance do we see hospital setting their automatic releases. I’ll tell you it varies. 

What we have looked at with many hospitals though, are, we’ve done lead time analysis, meaning looking at when cases are scheduled or created, to when they are performed in the operating room. If you still are on paper booking, that is a metric that can be analyzed. It might take a little bit more time than those of you that are on electronic booking but it is still attainable to do, and what I will tell you, why that’s important to do, is it will show you that the true data, which is it’s ikely that the majority of your cases are scheduled seven days or greater, 14 days or greater in advance. Something we’ve been recommending to hospitals is there’s really not a lot of reason to set your automatic release close to the actual date of service, meaning it’s more beneficial to create an open marketplace where more people have access to produce a higher yield. 

So if you were to set your release time at two weeks, chances are there’s going to be enough blocks or times unused that individuals need to schedule cases less than two weeks or less than seven days will get access. Are there some other tools that iQueue offers? Mobile time exchange through the device of your mobile or your computer can be actively looking at when there’s time available on the schedule. That’s back to my other point of increasing transparency. So I hope that answers your question. If you’d like to specifically email me or have a chat on the phone later today or this week, I’d love to continue that discussion. 

Li: And in case, the question is asking how often and how much data the app is suggesting people do see, we are suggesting that people should look at the supply table or the Collectable Time analysis at least every quarter to keep to the up to date performance of block usage. We are suggesting people take a look at both past quarter of ORs and past year of the block usage, which is our or like already like packed like the supply table you’re able to see, for the collectable percentage and decisions we’re suggesting, which is the number of blocks that we should take away among our adding blocks allocated. 

We are using both past quarter and past year data. And we’re actually using the one period that’s more favorable to the block owner. To give you a simple example for the past quarter, we are saying that Dr. Smith should be taken that way one block per month and for the past year, we are saying that you should take away two blocks per month, then we are going to use the smaller number of the two, which is one block per month, because that’s something that the surgeon might come back and say, I have improved my performance in the past quarter. So you should look at more recent behavior to make your decision. So we’re using that to make your arguments a bit easier. 

Moderator: We have a few more questions here. And I also want to remind everyone if you have a question, go ahead and open the Q&A box and we’re more than happy to field your questions. The next question is, will this presentation be available to attendees? Yes, it will post webinar, you will have a link to a recorded version of the session.

Let’s see. How did you get your surgeon buy in at UCHealth?

Walsh: Sure, absolutely. One thing that we really started to do, before really rolling up the concept of Collectable Time, we knew we had opportunities. We had low block utilization and high room utilization. I had high add on percentages. A lot of those add on percentage, a lot of those cases, were elective cases. But because of the way our block system was set up, they weren’t able to grid those cases and get them on the schedule in enough advance. So the first thing we really started to do to get our surgeons involved in thinking about things a little bit differently was, when I mentioned, was increased the transparency. We were good about reporting, we were bad about sharing. I’m giving myself a bad even though I emailed physicians every month, their staff and reports, I put them on communication boards etc., but that’s a poor way to get the word out, truly, at the end of the day. Because you’re relying then on everyone stopping and looking or stopping and opening their email and really looking through the details of the attachments. Providers are very busy. We all are very busy in hospitals. And to add one more to do to them remembering to go to their email, or go to the communication board and read this was a challenge. 

So we started to do with pushing metrics directly to the providers for a very simple text message. So once a week, our providers started getting text messages on their mobile phones. What happened very quickly was a domino effect. For the providers, we started with, they were hanging out in pre-op and talking about their staffs with other providers and other providers said, how do I get that information? So it was just a very easy, simple tool to send a text message and get them their metrics right in their hand that are meaningful to them. So I didn’t send them a report of the whole OR, I sent them a report just to them. That was very simple and very easy. And I underestimated how powerful that would be to be honest, because it ended up being quite powerful. So that was one way we started increasing the transparency of metrics, got providers talking about more. 

The second way was, we introduced an opportunity for them to see into the schedule themselves. So we introduced the concept of mobile block exchange or mobile time exchange. It’s also a tool that we’ve offered to the suite of tools iQueue, and they were able to look into the schedule or their schedulers were to see when’s time available. What happened there was two things. One I got physicians to start releasing more blocks. We published that in that case study. So you can see more detail in the case study. We made it really easy for them to release blocks. We also educated that we weren’t going to penalize them for releasing blocks, that it was doing a good thing. So that more people could get access to the OR sooner.

The more blocks started getting released, providers could look into the schedule. So instead of having 30, 40 add-ons a day, which a number of those were elective. Those elective cases, their offices were able to see in advance when time was available, request that time to say, I would like a block on that Wednesday when Dr. so-and-so released and put the cases on right then and there. This was also a huge win for schedulers because the surgical schedulers and the clinic schedulers deal with a lot of phone conversations, post it notes, emails, you name it to, when he releases his block. I should communicate that with her or vise versa. And this allowed everything to be done electronically. So we saw that frequency pick up in the amount of block releases on request. 

 So I saw another question come in, how can it be leveraged if hospital has a large percentage of add on. I touch edon that a little bit right there. I would challenge you to look at the types of add-ons there are. So add-ons can be all different kinds. They can be urgent emergent. They can be life and limb or they can be elective. If a number of your add-on cases are elective, I highly suggest that you invest in a tool that allows people access to the OR sooner so cases can get scheduled sooner for their advantage, then, of doing the deep analysis on what type of add-on cases you’re seeing or it helps you identify then as a leadership group, how much time should use that as open to absorb those urgent emergent add-on, versus how much time should you be blocked out in blocks? That’s something that is often hard to do. And if you are able to do that analysis on those add on cases, if you’re able to utilize tools like collectible time to see how much time as you allocated in blocks that really you shouldn’t have allocated. That also helps free up Open time for the true urgent-emergent, life-and-limb needs. Hopefully that answered your question.

Moderator: Well, thank you very much Ashley. Looks lik, that’s it for questions. I want to thank Ashley and Zetong for the wonderful webinar today. And of course, all of you who participated, Please keep an eye on your inbox for a link to the recording of the session as well as announcements for future webinars. A note, lease complete the survey that will be presented to you as you leave the session. It should only take about 15 seconds and it helps us make sure that we can tailor further content for you and meet your needs. Also please remember, and we have the contact info up on the screen here. Please remember you can text your email address to us, or you can email us at And thanks again, everyone, for tuning in. We enjoyed spending some time with you today. Thanks a lot.

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