Perioperative system helps surgery department transform OR utilization
Dr. Kathy Cho is an anesthesiologist at University Hospitals Ahuja, part of the University Hospitals health system in Ohio, as well as the head of the department. In addition to her clinical responsibilities, she is tasked with managing operating room block time and utilization for the entire surgical department.
To do this properly, and identify opportunities to gain efficiency, she needs accurate, real-time data and predictive forecasts that she can trust.
“Our old system provided data that was several months old,” she explained. “I was always working from a historical perspective, and there’s not much we can do to change the past. I needed real-time data that could tell me what was happening that day. What is the OR block time schedule? Has block time been released by a surgeon? Is there an OR sitting idle? How well did a surgeon utilize OR time? Do we have appropriate staffing based on projected volume?”
The other major challenge with the old system was that it only provided data in broad strokes and that information wasn’t always clinically relevant. The system lacked the sophistication to drill down through the data.
“For example, if a particular surgeon only had a 46 percent utilization rate for a particular day, I wouldn’t be able to see why the utilization rate was so low,” she said. “Understanding the ‘why’ is so important to improving utilization. Did the surgeon forget to release block time? Did another surgery run long? Did an emergency surgery disrupt the schedule?”
Cho needs detailed answers before she can make the right choices. When one does not know the daily utilization rate, it is very difficult to know what the volume is, and then make the appropriate adjustments in terms of OR rooms and staffing.
“I needed a solution that would provide accurate, detailed data in real time, otherwise I would only see a piece of the picture at any given time,” she explained. “Our analysis and subsequent plans to improve efficiency would fall short of our goals.”
University Hospitals Ahuja chose vendor Hospital IQ’s perioperative system to improve surgical block scheduling and utilization. The platform allows Cho to pull data from existing systems and analyze the data in real time. The advanced analytics capabilities let her accurately forecast OR usage and make recommendations that will improve block, OR and staff utilization, she said.
“The Hospital IQ team set up the system in accordance with how our surgical department runs,” she stated. “Even though Ahuja is part of the larger University Hospitals network, there are differences in how every surgical department runs. We have a different patient mix and different surgeons so we need detailed, customized reports that are applicable to our department.”
"The system lets me create surgeon scorecards, which democratizes key metrics for each surgeon, including block utilization, cancellation rates and late first-case starts."
Dr. Kathy Cho, University Hospitals Ahuja
Not only does the new system allow Cho to look at the broad strokes, such as OR utilization, surgeon block utilization, first-case on-time starts and cancellation rates, but it also allows her to drill down behind those numbers to understand what is driving them, she said.
There is a variety of perioperative information systems on the market today. Some of the vendors selling these systems include GE Healthcare, Medhost, OR Manager and Surgical Information Systems.
MEETING THE CHALLENGE
Cho’s approach to the new system has been to tackle specific areas rather than do a little bit of everything all at once.
“When I started using Hospital IQ, I focused on block utilization and block releases,” she explained. “The system lets me create surgeon scorecards, which democratizes key metrics for each surgeon, including block utilization, cancellation rates and late first-case starts. Surgeons are able to see the impact they have on our performance and compare themselves to peers. My next area of focus will be on-time first starts.”
Hospital IQ integrates with all clinical and non-clinical information systems. In Cho’s case, the main system that Hospital IQ integrates with is the OR scheduling solution, called Sunrise Surgical. Hospital IQ takes the data from this system and calculates OR and block utilization.
“One of the challenges I had before using Hospital IQ was managing surgeon block time,” she said. “Surgeons would forget to release block time before heading out on vacation or attending a conference, and we weren’t holding them accountable for unused OR time. As a result, we experienced volume fluctuations. ORs sat idle. We didn’t have the data to isolate and fix the problem.”
The new system helped her clean up that process and make surgeons accountable for releasing their block times, enabling other surgeons to use the OR. In this way, she has been able to optimize utilization and increase volume.
“In addition, Hospital IQ has helped me understand the detail behind the numbers and that has made it easier for me to make decisions,” she said. “Before using the new system, I might receive a report that a surgeon’s utilization rate was 46 percent for the day. But I had no idea what drove that rate. This is important.”
In the past, Cho may have penalized a surgeon by reallocating that time. Now with the new system, she can see all of the surgeon’s cases performed in a given day. A closer look may show that the surgeon with the previous block ran over on time, disrupting the schedule of the surgeon with the low utilization rate.
“In fact, recently we flipped scheduled block time for two surgeons,” she explained. “Data from Hospital IQ showed us that the surgeon with the morning block always ran over, while the surgeon with the afternoon block used his OR time perfectly. I used that data to justify flipping surgeon block time schedules, and it has worked beautifully.”
The predictive capabilities of the new platform have been a tremendous help to Cho.
“I use the block availability feature, which allows me to look ahead and determine OR availability,” she said. “I can work with surgeons to fill released time several weeks in advance, which directly improves OR utilization. The predictive capabilities also help me determine which surgeons will need more time, less time, or different block time altogether. The solution even indicates the statistically optimal time for a surgeon to release a block.”
Since using the new system, there have been several measurable results, including:
- Improved block utilization from 76 percent to 79 percent;
- Improved block releases from 8 percent to 13 percent;
- Improved prime-time room utilization from 82 percent to 85 percent.
“While these increases may seem minor, in a surgical environment where one minute of OR time is worth $37, the improvements that we’re achieving on a daily basis have a big impact to our efficiency and bottom line,” said Cho.
ADVICE FOR OTHERS
“Using advanced analytics has been instrumental in allowing me to do my job to its maximum,” Cho advised. “The new system has given me the power and the insight to increase OR utilization and efficiency beyond my initial expectations. It’s been critical to not only getting the right data at the right time, but manipulating and understanding it.”
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