Webinar Transcript: Beyond surgical block time utilization – How McLaren Health Care transformed its OR operations

At the LeanTaaS Transform Winter 2021 event, Binesh Patel, MD, Chief Medical Officer, McLaren Health Care’s Flint Hospital, and Tyler Baker, Product Implementation Manager, LeanTaaS, iQueue for Operating Rooms, discussed how McLaren Health used iQueue to develop metrics that gave context to surgical block time utilization and improve how surgeons used times, rooms, and resources. 

View the whole session, or read a blog summary.

Moderator: Welcome to today’s session, how “McLaren Health is Transforming its OR Operations,” at the Transform Better Healthcare Through Math Hospital Operations Virtual Summit. It is my pleasure to begin today’s program by introducing the speakers, Dr. Binesh Patel, CMO at McLaren, followed by Tyler Baker, Production Implementation Manager at LeanTaaS, iQueue for Operating Rooms. 

Dr. Binesh Patel is a practicing board-certified emergency medicine physician that has served in a Chief Medical Officer role for the past nine years. For the past four years, he has held this position at McLaren Flint Hospital. He also oversees the perioperative departments, which pre-pandemic experienced a year-over-year growth by improving efficiency and access.

Baker: So a quick background about LeanTaaS. We were founded in 2010, based out of Santa Clara, and as we quickly grew over the years, we created a presence nationwide. In terms of our product, iQueue and we have three platforms, Queue for Operating Rooms, which we will focus on today, and iQueue for Inpatient Beds and iQueue for Infusion Centers.  

Within OR, we’re now with 475 hospitals, and incorporated with 120 health systems. All that means is we’ve had a great level of exposure not only with community, but also academic hospitals. We’re also working with systems customers, so large scale clients, as well as local hospitals so we meet the needs, depending on your particular facility. Over the years, we’ve gotten very intimate with a number of EHRs, so we are quite familiar with Cerner, Epic, Meditech, Paragon to name a few. 

What this means for each and everyone of you is we do a lot of the heavy lifting during implementation. We’re able to scale perfectly, as we’ve already worked with a number of these EHRs before, we can streamline the implementation process. That’s what’s really helped us be very successful. 

Now we all know this issue, that OR time is unpredictable. This visual is just a breakdown of Orthopedic Surgeons by volume of day. We know that your schedule is quite volatile. Now it could be you know, related to the add-on percentage, whether or not they’re urgent or emergent. It just depends on the waxes and wanes of your schedule. 

Now we’re dealing with COVID, there are a lot of staffing challenges that come into play, as well as anesthesia constraints and contracts that play a factor. This right here is just really exuding a volatile schedule that you can’t necessarily plan for. But what iQueue will allow you to do is identify underutilized time, whether that fits within your block schedule with being able to squeeze in that additional open OR time. This allows you to not only admire the problem but course correct it, knowing how to address the key issues. In turn, hopefully you’re being more proactive. You’re adding dates into your scheduling, so you’re not scheduling next day or the day after, you’re able to be more nimble and command to coordinate. 

Now iQueue really goes to these three issues within the OR space, the first of which is limited OR access, and that could be a plethora of factors. But really what we hear is that vicious cycle of surgeons not releasing their surgical block time. They’re scared they have that stigma that no time is available. So whether or not they’re going to use their surgical block time or not, they’re not going to proactively release it, because they may add on some of those incremental cases a day or two in advance. 

Now also, the scheduling process could be a little clunky, it’s manually intensive. There’s a lot of back and forth between clinics and your OR scheduling. What iQueue is really going to do, it’s streamlined end to end solutions where it’s adding time back into the schedulers’ day and really advertising true availability. 

Secondly, we want to hold block owners accountable. Surgical block time utilization is an imperfect metric. It can be fundamentally flawed because it’s just gathering total block allotment and we know that every block has a different case mix, different complexities that all play a factor, and what iQueue is going to do is distinctly and uniquely create a combination of block owner day of week and location, to really give you those common themes where there’s opportunity in block. 

Lastly, we want iQueue to be the single source of truth. You’re no longer admiring the problem. Instead, you’re solving it. So you can get near real time data to where you can identify and standardize your key performance indicators and create internal initiatives. And now I want to pass it on to Dr. Patel to speak a little bit more about McLaren.

Patel: Thank you, Tyler. I’d like to start just reading our mission statement: McLaren Health Care will be the best value of healthcare as defined by quality outcomes and cost. 

We came up with this mission statement in 1996. And I stated it because it’s still applicable today in today’s environment. As we look at our health system, we’re fully integrated in fiscal year 2019. We had $5.1 billion in revenue. We’re spread out across two states, in terms of acute care hospitals we have 14 hospitals in Michigan and one in Ohio, that comprise 3000 licensed beds in over 300 inpatient ambulatory care facilities. We’ve had a long standing insurance company here in Michigan, then we also have expanded into Indiana. We have a Population Health Structure with a physician partner group that is a PHO style, risk-bearing model, a high performance network which is Accountable Care Organization in our McLaren CIM, clinically integrated network. 

We also happen to have the largest cancer treatment network in Michigan and we’ve been able to spread that across the entire state so that we can deliver cancer care all across the state of Michigan, and now expanding into Ohio. I’m also proud of our graduate medical education program. We have 654 students, interns, residents, and fellows all across our site. We have 2600 employees. We have a community benefit that exceeds 300 million. 

Let’s about some of our recognitions. We have recognition from all accrediting regulatory bodies  including third party organizations like health grades and Consumer Reports. One of our strengths is that we are in several markets across Michigan, no other health system in Michigan can boast the number of markets that we are involved in, and we are number one in market share in several of our service areas. So we have a strong network of peer relationships. 

Again, this speaks to our broad reach across the state. We’ve been consistent with our financial performance, again, alluding back to our mission statement, the mission statement in delivering the best value in healthcare. 

So I want to talk about why we engage iQueue. LeanTaaS provided us with a solution and we were able to look at the problems that we had and recognize that this solution would work for us. For instance, limited OR access. How do we get those physicians that didn’t have block time for instance? How do we get them to be able to get access to our OR? Low accountability for surgical block time utilization? Again we were actually very lacking in our data to be able to show what the surgical block time utilization was. With iQueue we were able to bring that data to the forefront in a format that makes sense to the surgeons. Then, of course, limited visibility and transparency again, without that data to be able to show the surgeons it made changes that we wanted to do or anything that we wanted to enhance very difficult, because of the lack of data to support what we wanted to do. Folks didn’t have good access to that data as well, and so this again allows not just the data to be forefront but actually provide the access to those individuals. 

Let’s take a look at the different aspects of iQueue for Operating Rooms and how we’ve been able to use this in the McLaren system to maximize our operating room utilization. One of the nice features of the product is the request and release block capability, because it’s a web-based application. The surgeons and their clinic staff can easily log in and look for open time or if their surgeon is going on vacation for instance, be able to release their blocks to open up that time for other surgeons to then utilize. 

The concept is very similar to an OpenTable concept for restaurants. If you have that app you are very familiar with that concept where you can go in look for that available reservation time for your restaurant and then select it and book that time space. It’s very similar in iQueue for Operating Rooms. You can go in, and actually what you do is go in and place your request, and then it’ll pull up all of the open spots based on the variables that you’ve entered in and then allow you to request that time. Now on the operating room side with our schedule, we still have to ensure that because requests that came in are appropriate for that time and accept it, but we have found that our acceptance rate is exceeding 98%. And so it makes it very convenient and eliminates that back-and-forth phone call between the office and the OR to try to get that add-on case later to be boarded. 

Another nice feature is, just imagine if every surgeon has a release time for their block and automatic release time of say five days. That may not be appropriate for the different specialties. You may have some that a five day release time would be appropriate for but you may have a group of surgeons, a particular specialty, that boards 90% of their cases in 14 days out, and so if they don’t get anything boarded into their block at 14 days out you can pretty much assume that they’re not going to use that time, so potentially you could set their release time at 14 days. Whereas on the other end of the spectrum you may have someone that really that specialty is much more acute. And they may need a release time of two days. So you can set these, what we call automatic nudges to the surgeons and their clinic staff at the time that’s appropriate for their specialties. 

So you may have one specialty at 14 days, another one at five days, another one at two days and then sort of nudge that team that OR or that clinic team that hey, you’re at this mark where typically you would have boarded 90% of your cases if you want to consider releasing that time. Of course, that group that’s it that 14 days, they release it, it really opens up that space for other surgeons that are looking for time to get in there and do their cases. And again using that OpenTable concept as those blocks are released. They can be accessible in the Open Table format. 

Another piece of the iQueue for Operating Rooms is the ability to send out these alerts and again the alerts could be either to the surgeons or even to our staff. One of the alerts that we send out to the surgeon is just the monthly data. How are they doing in terms of their surgical block time utilization and operating room utilization? How are they doing their release request? How accurate is their caseload? These are all tools that the surgeons want to know, so that they can better refine how they practice and how they board cases. 

Another aspect of it is anecdotally we always know, okay, we can look ahead and say oh yeah, that Monday coming up is probably going to be a busy Monday, the Tuesday coming up probably not so busy. But we don’t have the data to support what we’re actually saying. Now we do, we can look and try to forecast what’s coming in the upcoming days based on how we’ve done historically, and it provides that information much more transparently. And faster, so that we actually can have data support. “Oh yes, that Monday upcoming is going to be a busy day for us. And so how do we properly staff the OR and all the periop areas?” 

Another nice feature that I like is the ability to look at the data on my cell phone. I can just keep that link open and continue to see the updates almost on a daily basis. At any time. I could be sitting in a meeting and want to know how a particular surgeon is doing for the month, or how they did over the last six months, I can easily get to that information. 

LeanTaaS was able to work with us at McLaren to come up with the metrics that made sense for us. And then really cater that dashboard to those metrics that really made sense to us. And that was a nice feature that we were able to take advantage of.

Finally, just additional value that we can get is looking at that accountability. We can look at all of these different tools that come with the data that is generated and applied in different ways, to look and see how we can make our ORs more efficient or more open. For instance, if we look at the bottom left tile, that Surgeon A or Surgeon B, both of them have essentially the same surgical block time utilization percentage. However, when you look at Surgeon B, how do you squeeze cases in there if their schedule looks like that? Whereas in Surgeon A, you can see that there are two full days for cases. They have basically the same surgical block time utilization. However Surgeon A, to give up huge blocks of time that can be accessible to other surgeons. The support tools that are available through here again, looking at the data in different ways, has been extremely effective for us to be able to either right size blocks, take blocks away, add blocks, etc. Within three months of going live we were able to make some significant changes that otherwise would have taken us much longer to do. 

Now we started this process at the end of 2019. We began the implementation phase at the beginning of 2020 with a go-live at our pilot location at McLaren Flint Hospital in March of 2020. We all know what happened in March, and so it did push us back by about two months. Which actually, we were able to take advantage of that implementation, that go-live date, because we were coming out of the lockdown in March and April. We’re planning across the state to open up, and so we use that date as the timeframe when we would roll out iQueue for Operating Rooms, and so it actually worked out in our favor to roll it out at that time because it was almost as if it was a restart for us in our OR and within two months we were able to see that this was very effective at McLaren Flint and allowed us to then think about the rollout. In our Phase One to other sites. 

So we have now rolled it out to three other sites across healthcare. And in 2021, the plan was to continue to do more rollouts. We’re doing this in conjunction now with a complete EMR change across the health system as well. And so we have some competing priorities that are causing us to pick and choose our time frames of when we want to go live. Our hope is that by the end of this year or early part of 2022, we will have rolled it out to four more sites. We have seen tremendous activity utilizing iQueue at the four sites that are up and running. And it’s interesting because each site is a little bit unique and has utilized this to gain efficiencies in different ways. 

Baker: Having the pleasure to work with the implementation with McLaren. Exchange enabled McLaren to be faster and have an easier process for scheduling. We were able to do a case study, kind of monitoring the pre and post results with iQueue’s implementation. Prior to iQueue, a lot of physicians and clinics would call into OR scheduling to release that time. It was a manual process where they were tracking this in an Excel spreadsheet. And it really just took a lot of effort for OR scheduling. 

What iQueue allowed us to do was push the accountability forward to where we engage with the physicians, where physicians can easily log in at their discretion and know their schedule well in advance. They can go in and quickly release a block and it’s going to go unused. So we talked about those release reminders where it gives that gentle nudge that’s one extra piece of automation that really drove an increase in those releases and you know, increasing or unlocking that OR capacity made all the difference. As a result, we saw more of those open time requests come through. Now what we were doing, working with McLaren, is they were unlocking what used to be predominantly block time to where they can flex in additional open time for physicians. And what this did was it allowed McLaren to really go after growth and work on recruitment for specific service lines. 

If there are physicians that come on board that might not be granted block time immediately, they were able to use iQueue, Exchange specifically, to be their source of truth to be able to add on those elective cases so they could board all those additional cases and meet their volume needs. Again, it was a win-win because it was eliminating that vicious cycle as we mentioned before. Now we started to track, within Exchange, periop leadership has the ability to look at adoption and that’s what we consider statistics. 

We started to monitor the result. We went live in the pilot site, in Flint, in early 2020. Then in October 2020, we went live with four additional sites, which we consider to be Phase One. Since then, they have had over 2300 approved requests, which totaled, you know, over 250,000 minutes, and subsequently, we’ve had over 1000 releases. 

Now with all of that taken into account, the biggest shining star in all of these metrics is the proactivity. All of these requests and releases are well into three weeks in advance. And again, it’s all about addressing that volatility. This allows staffing to be more consistent. You can plan accordingly. And what OR directors and managers are doing is bringing this data to their daily huddles. Exchange will also show availability days in advance. So this is not only advertising that open time, but it’s making an open source and OpenTable- like concept to where all of these incremental cases outside the block can be added. So not only are physicians happier, it’s giving you that competitive advantage. These are not only tools that make the scheduling process that much more seamless, but also allow surgeons to engage with their data. And there’s a lot of automation baked in, to where we can push the data for physicians to opt in for text messaging, for instance, to where they can go in and see their metrics as a whole. Now, this is very impactful for physician relations, because they can see all the requests and releases that are coming through, they can see who’s on the leaderboard or their high margin or high volume surgeons on the list. This allows them to really know where they need to focus. If they’re doing rounds with the clinics, they can say “hey, there might be a little bit of an education gap or we’re not seeing as much volume from, you know, Dr. Baker’s clinic for instance.” So it gives them full visibility to make those reports corrections and really know where their efforts are needed. 

Data transparency goes a long way. I talked about strategic decision making earlier, but this is going to be very, very pivotal for periop leadership because not only are you amidst the multiple waves of COVID, now as you’re dealing with staffing constraints and vaccination requirements, challenges are not going away anytime soon. This allows periop leadership to really go in and see the waxes and wanes of the schedule. So in this example down below, we can see that we’re looking at the main OR and how this location is performing on Wednesdays and this is a location that has a specific room that is robotic related. So this is a robotic room with a Da Vinci device. And this will basically show you full, full time that’s allotted within that room and how many cases are being performed and then you can quickly determine, “Okay, we might allow non-robotic cases to be performed in this room, but I want to see the robotic case mix.”  

This gives you a nimble way to look into the future to determine when an additional purchase for robotics is needed. Maybe you’re not maximizing what you have, so it’s kind of that cost analysis and really drives those hard conversations with your business department and your CFO. 

Now, secondly, the automation of data goes a long way. It’s all about that surgeon’s engagement. We had an initiative working with Dr. Patel about engaging as many surgeons when possible. We know that a majority of physicians are hands off. They are stuck in their routine and that’s it. But there were a lot of physicians that were very eager to look for that opportunity to maximize their volume and continue to grow. So this way we can actually push their weekly metrics as well as monthly periop leadership metrics on a weekly and monthly basis. And what this will do is give a week over week comparison of how they’re trending. But also it gives deep-data drill downs, where they can go in, click the link that goes directly into the application, then they can slice and dice the data as they see fit.

Now lastly, it was all about unlocking that OR capacity. That’s really what Collect was able to do for McLaren. Working with the OR Director in the pilot site, we were able to really hit the ground running, and it really just facilitates data-driven decisions and it’s meant to be unbiased. It is still going to be surgeon-centric. A lot of people think that repurposing block is a negative, but it’s really looking for the common themes of where physicians like to perform. So in this example up top, we can see what the block allotment by that blue line, red is access, and the green is that surgical block time utilization. We can see the waxes and wanes were blocked with either removed or awarded. But this basically will correlate additional block time and if you saw an uptick in the volume. 

Now we can see in this example that this is a flip room position, and he is predominantly leaving time on the table late in the day. This is where it gives periop leadership ammunition to drive those hard conversations. We can say “Hey, Dr. Baker, based off of what you’re seeing here, we can see that you’re pretty good about utilizing your block in the morning, is there a preference to where we can trim this down, maybe consolidate your cases into one block for instance, maybe based off your policy, this position doesn’t warrant large enough volume to warrant that flip room?” So again, truth is in the data. 

So this is a mechanism where you can bring this data to your block governance to really drive those conversations, collaborate, and identify next steps. 

Patel: One of the unintended benefits of bringing iQueue into this was the ability to actually create some system across all of our sites. I mentioned before we are in this migration into a single EHR platform unfortunately today, all of our sites are on standalone EHRs. However, by bringing iQueue in tt forced us to have to think about standardized processes across the organization so that when we do migrate, when all of our sites have migrated to that single platform, we’ll all be on that standardized process. So for instance, you know, how do we consistently close rooms that are not being utilized? And then how do we track that staff, through surgical block time utilization or other utilization metrics? It’s important we’re tracking in the same way across all of our sites so that surgeons that may bounce from one hospital to another can be tracked accordingly at each site. It also allowed us to create super users of our OR schedulers to give them the same processes and practices so that they can reinforce them, no matter what site they’re at. 

So when we talk about the staffed room utilization and creating that standardized process across all of our sites, we can now track it and compare each hospital, and you can see where we have landed and this is just year to date, in 2021 you can see how each of our sites that are live are doing. Wherever we see drops in performance, we can go back to those locations and determine what happened. Were they following the proper processes that we’ve put in place. But overall by giving this visual, graphical format, allows us to see how we’re doing and understand how we can continue to do better. We’ve set internal targets of being above 75%. And that’s the goal is to be above that 75% for staffed room utilization. 

Another one of the key metrics that the surgeons at Flint wanted to know was okay, so we have these delays, particularly in first cases, who’s causing that delay and we didn’t have a good format to be able to report that and so we created that format and allowed iQueue to pull that data so that we can see what’s going on. We had too many cases that were essentially undocumented in terms of case delay. It made it very difficult to blame the surgeon, the patient or the staff or anesthesia when you have so many cases that are being undocumented. 

Once we can get those cases and appropriate delay code then allows us to be more confident in where our gaps are to be able to go over that. And you can see that our case delay has dropped through this. 

Baker: Working with McLaren’s champion Dr. Patel, we wanted to really focus on the first year, year and a half worth of data. And really we started to monitor, okay, based off of the block schedule and the improvements in best practices that we initiated with the help of iQueue, we wanted to identify where there is potential in the block schedule. And really what we worked with with the OR directors was really drilling into what are the parameters for identifying collectable time, and really it boiled down to how much time do we want physicians to release before we identify as collectable? If they release too much time it just means that they have too much block that’s allotted. And then based off the OR, we’re focusing basically on outpatient surgery centers and then based off the case mixes, that two and a half hours of continuous time would be deemed identifiable for flexible time. So with all of the sites included, we can see that they’re on a quarterly basis, there’s 671 surgical blocks that technically make sense. Now this could be a small portion of all day blocks. It’s not necessarily full 480 minute blocks.

Now based off a good calculation of contribution margin and a respectable repurposed surgical block time utilization. We can identify there is a potential 48,000 minutes that can be added to the schedule. And that’s huge. But then we wanted to pivot to, what is McLaren already seen today? And based off of those incremental cases that have come in over the last year. How can we create a contribution margin so 20% of those may be warranted because of iQueue? We can’t take all the credit, but based off of those incremental minutes that have been added since November of 2020. They’ve already been able to claim 47,000 additional case minutes, which is phenomenal and a great case study dating back to the pilot site there at Flint. 

Now as a whole, we’re talking about McLaren, a huge system. They span all across Michigan, and there are different nuances, different struggles at each site. But what we wanted to do was hit the four pillars. And really what it boiled down to was consistent workflows and metrics. So creating standardized key performance indicators that can be repeatable, each and every site that goes live with iQueue. And then we wanted to make sure that EHR best practices are what I know, is hygiene consistent, to say “hey, to make sure that staff room utilization is accurate.” Are we closing rooms down? Whether these are half day, full day, chunks of time, you want to make sure that you can accurately measure the utilization of the rooms that you plan to staff.  Then we want to make sure that you have accountability and that’s where Collect comes into play. So that’s giving the ammunition to the OR directors to really fine tune, drill into the data and pretty much engage leadership into those discussions within governance committees. And really that’s looking at those group blocks, those individual blocks to find out where that opportunity is. So it’s going to promote growth system wide. 

And lastly, we want transparency of data. Not only is this for your periop leadership where they can be nimble and monitor their own data day-in day-out, but we want to foster that competitive advantage. If you’re in a competitive market, every tool and every process that makes it that much more seamless can make all the difference in terms of recruitment. So those are the four big pillars that we wanted to make sure that we’re getting there at McLaren and they have been a shining star in the implementation process. 

So I’d like to then pivot over real quick to questions. 

Moderator: Thank you so much, Dr. Patel and Tyler, for this fantastic presentation. Now we would love to take some questions at this time. If you have any questions for our presenters today, please type them into the Q&A box now, but I will go ahead and kick off with our first question that has come in for Dr. Patel. Which is why go forward with iQueue’s implementation despite different EHR and EHR migrations. And you know, can you describe how iQueue assistance during migrations? 

Patel: Yes, again, one of the two of the things that we looked in 2019, when LeanTaaS came with this solution was we had an inability to produce good data, inability to make that data transparent to our stakeholders, such as our surgeons. That was one, and number two is how do we make the process of boarding cases outside of your block time more streamlined, and LeanTaaS came forward with this iQueue for Operating Rooms that was actually able to solve both those problems in one solution. And this has allowed the surgeons and clinics to be much more streamlined, much more efficient in their clinic time. Again, they’re not spending all that time back and forth with the OR, trying to find space to board their surgeons cases. Then finally, the transparency of the data has been overwhelmingly positive. Share the good and the bad. And so we share the good data to the surgeons that show how we’re improving on staff utilization, how we’re improving the first case on start times, but we also share some of the bad data, what is causing the delays in our first case, and is it the surgeons, anesthesia, etc. And what are we going to do, what action plans will be put around each of those delays, and it’s allowed us to capture all of that and target those opportunities and work out ways to improve. 

The other part of the question was about the EHR. Yes, we had multiple EHRs. We knew that we are going to be moving towards a single platform, when LeanTaaS came forward and said that they have worked on multiple platforms. That gave us confidence to move forward, even though today’s platform may not be tomorrow’s platform. LeanTaaS will be able to help us smooth the transition from our current EHRs to our future singular platform. So we were not worried that we would lose traction there. 

And as I mentioned earlier, it did allow us to create standardized processes early on, even before we started transitioning to the singular platform. So now it actually made our life easier when we did move to the singular platform that we didn’t have sites coming live on on the new EHR saying okay, what are the processes that we’re supposed to be looking at? They already knew because they’ve already been there. 

Moderator: Okay, thank you for your insight Dr. Patel. I know you mentioned standardization. Another question is, how would you say iQueue has promoted standardization across your system? 

Patel: Again, it’s transparency they added. So as LeanTaaS has been able to show the data, with all the different metrics and put it up there in an organized format. It has allowed our OR staff from across the organization to look at that and say okay, does this meet our goals? Then that has allowed the team to meet centrally to say okay, we need to tweak this tweak that. 

Tyler brought up a point about collectable time, what is defined collectable time that we’re going to utilize? And we settled on two and a half hours by talking amongst all of the sites to determine what makes sense. Some of our smaller sites that may not do large cases, maybe the two and a half hours, is a bit long and they could go a little bit shorter timeframe and some of our bigger sites, the opposite will be settled on the two and a half hours. Because we wanted to create a standard timeframe for the purposes of how we measured metrics.

Moderator: Thanks for sharing your processes there. And the next question, you know, how have you been able to get your surgeons to trust the data and what types of changes we’ve been able to make by this buy in, you know, for example, like building surgeon rapport? 

Patel: For sure. So, surgeons and actually all physicians are very skeptical of data unless they can essentially put their hands around them. And so we brought the data to them in its most raw format, early on, so that we could show that there’s no manipulation of this information. With LeanTaaS’ help, being able pull the information out. We showed them how we arrived at those tiles that showcase the different metrics. And that’s how we got the buy in. A lot of it was very easy for them to see because they live and feel it every day. So they just didn’t have the data to validate what they were seeing. Now we have the data to validate it. So for the most part, there really wasn’t a lot of challenges. Again, by showing the raw data and encapsulating that into those tiles, it made it very convenient for the docs to the surgeons and especially to to adopt it. 

Moderator: Great, thank you so much for sharing, Dr. Patel. And this question for either of our speakers: what impact has iQueue had on your or governance committee meetings? And does iQueue enable you to improve case accuracy? 

Patel: I’ll start off and then maybe Tyler can add to it. I will tell you that this was a much, at least at Flint, a much needed solution for us because of the lack of data. And so the instant we were able to actually showcase this even before we went live, we could look at historical data. Surgeons wanted this to be the first thing that they looked at in our governance committee. So I remember the first meeting that we had the data, we spent almost the entire meeting just looking at the data and the surgeons were overwhelmed with all the different metrics and points of information that they could capture with this. 

Baker: I can add a little bit there just working with OR directors, collectable time is a new metric  they’re not used to. So it’s essentially training them to know what to look for. So we really go through the process of looking for those stark differences in surgical block time utilization. Looking at a block owner that’s a really good utilizer versus someone that leaves a lot of time on the table, that’s where we really double down and look and ask those questions. What’s a reasonable amount of time you would like to repurpose? Do we want to focus and weed out certain service lines like cardiothoracic, for instance, because this is tying in rooms that you can’t really repurpose? So it’s really just training them to get into that mindset of how they drive the conversations within governance.

Moderator: Thank you both so much for that feedback. Now as we move into our next questions, similar topic here, does iQueue have data outside of main OR rooms? 

Patel: I’ll speak about McLaren and Tyler can weigh in with other sites. We adopted iQueue, specifically our main ORs and our surgical centers. We did not look at utilizing this in, say, our Cath Lab, at least not yet. Our main focus was to work with our surgeons, and I will add our endoscopy units, most of our sites are built in conjunction with our operating rooms. So we did push this on to the endoscopy sites as well but it’s mainly for our ORs and our surgery centers.

Baker: To really reinforce Dr. Patel, I mean, endoscopy suites main OR outpatient surgery centers are bread and butter. However, as long as any room has documented cases in the EHR, we can really pull them in and really help. That that drills down into, “Okay, cath labs, for instance, we’re getting more and more familiar there. We’re seeing it be documented.” More so the EHR, you know, recently so this is something where you know, we circle back on that Dr. Patel about the cath labs, but essentially, we can pull in most rooms as long as they’re documented with a EHR. 

Moderator: Again, and just another systematic question for either one of our speakers today. But how does this system factor in complexities in which surgeons and which cases can be accommodated at which times? 

Baker: Within the iQueue platform, there are a plethora of parameters, what we call settings and configurations. During the implementation process, we get quite intimate with the OR directors, as well as OR schedulers to really understand some of the scheduling needs per room. So if you have robotics that are stationary, okay, we can make rooms with specific hard constraints, that they only perform robotic cases. Maybe there are rooms that are specialized for cysto cases where it has the drain in the middle, we can certainly account for that. So we can create service line restrictions, room concurrency, max rooms, all in an effort to streamline that process for scheduling. Depending on the scheduler and who they’re scheduling for, if you have a ortho scheduler scheduling for three of their physicians, they will see the availability of the rooms that can actually perform ortho cases. This all in an effort to make sure we’re advertising the right time within Exchange. 

Moderator: Thank you for that insight there, Tyler. 

And it looks like we have time for one more question today for Dr. Patel. But can you speak on,  how did McLaren use custom iQueue setup configurations to account for the COVID impact on the hospital? 

Patel: Okay, so that’s a very current question. As I said, our original go-live date was the middle of March 2020. We had to delay by two months. In the state of Michigan the entire state locked down in the middle of March and really started opening up at the beginning of May. So we actually at Flint utilized this tool, as we reset our operating rooms in the middle of May, so it aligns very well. That’s just Flint. As we move through the rest of the year and got into October, we went live and three other sites. The opportunity there was to get those sites back to normal. This was the tool that they were able to use, so actually the way I would look at this whole COVID timeframe, Flint was able to utilize it as a reset. Then our other three locations were able to use it as an opportunity to get back to normal. 

Moderator: Wonderful, thank you so much for sharing Dr. Patel. And unfortunately that is all the time we have today. So I want to thank our speakers for taking the time to chat with us. And I also want to thank LeanTaaS for sponsoring this event.

For a fuller image of how McLaren Health Care achieved success by expanding on surgical block time utilization, view the complete webinar here.