For healthcare practices, ambulatory surgery centers (ASCs), and hospitals, the operating room (OR) can be a major cost. Inefficiency increases that cost significantly while also making adverse events more likely. On the other hand, an efficient and well-utilized OR can be one of the biggest revenue generators while also improving patient care and staff well-being. Let’s look at how to improve OR efficiency and utilization with these five research-backed steps:
1. Improve communications to reduce delays to first case starts.
Research suggests that one of the most impactful interventions for OR efficiency is to ensure that the first case in the OR starts on time (otherwise known as “First Case On Time Start,” or FCOS). A study by the Yale-New Haven Children’s Hospital found that optimizing the FCOS in the ORs resulted in approximate savings of more than $4000 a week.
However, improving FCOS can be challenging. Starting on time requires ensuring that the patient, surgeon, anesthesiologist, and OR nurses are all present and prepared before the start time, with all pre-operative assessments completed and all necessary OR equipment available.
One way to decrease delays to start times is to improve and automate communication with both patients and healthcare staff.
For instance, surgery scheduling software such as CaseCTRL can allow surgery schedulers to send automated reminders to the patient, surgeon, and other support staff in the days leading up to surgery. This way, everyone knows that where they need to be and when they need to be there. Automation reduces the risk of human error and cuts down on the manual labor for surgery schedulers.
2. Use strategic staggering to optimize OR use.
While unexpected events cannot be completely avoided in surgery, improving the strategy used when scheduling surgeries can significantly reduce the delays caused by surgeries that run on for longer than expected.
For instance, using a scheduling software with an analytic capacity will allow you to develop a more accurate estimation of how long each type of surgery is likely to take, thus maximizing the use of resources without impacting patient care.
Additionally, the use of a centralized, shared digital case posting software will allow surgeons to flag up the need for specific OR equipment, ensuring that it will be ready for surgery and that schedulers cannot accidentally assign the same equipment to two concurrent surgeries. A Yale study identified OR equipment readiness as one of the key drivers for starting more surgeries on time.
Finally, scheduling software will allow schedulers to make more strategic decisions about when surgeries should be scheduled. For instance, more complex surgeries with more potential for variable duration can be scheduled for later in the day to avoid disruption to the planned schedule.
3. Ensure all patients are prepared for surgery.
Issues with patient preparation can be a significant factor in delaying surgeries and have a negative impact on how to improve operating room efficiency. The use of a pre-operative checklist can reduce these delays by helping to identify issues before roll-back to surgery in a single standardized process. The checklist for how to improve operating room efficiency should include the following:
- Confirming the identity of the patient
- Checking which procedure they will receive
- Making sure all relevant assessments and test results are available
- Listing any patient allergies
- Confirming the availability of anesthesia
- Checking that the surgeon and medical team have discussed any potential critical events
A surgery scheduling platform can help schedulers catch any missing elements before the day of surgery. By providing a centralized repository for all necessary case information, staff can verify that all lab work has been completed, all required patient and scheduling information has been provided, and that the patient has been notified of what they need to do the day before surgery, the surgery start time, and the time they should arrive.
4. Reduce patient-related case cancellations.
Cancelled surgeries can throw off the scheduling of the OR for a complete day, reducing profitability for the healthcare practice and potentially impacting the patient’s health by delaying the surgery until it can be rescheduled.
To reduce cancellations caused by delays in the OR, aim to improve the scheduling accuracy for the two major components of a surgical procedure – the anesthesia and surgeon time. For instance, a study published in the Journal of the American College of Surgeons used historical data to improve the accuracy of the predicted time for anesthesia induction and emergence. The researchers were able to decrease the time prediction error for anesthesia by 4.5%, showing an overall reduction in surgery cancellations of nearly 20%.
A scheduling support software with risk analysis features can help you curb cancellations in your own practice in a similar way, automatically learning from historical data to flag cases where surgical complications are more likely to occur and take measures to proactively improve patient satisfaction.
Of course, an easier way to avoid the cancellations caused by OR delays is to make sure that everyone knows that a surgery is running behind schedule so that alternative plans can be made (such as moving the surgery scheduled after the delayed procedure to a different OR). If you’re using a manual system, this can be extremely tricky to do. Schedulers will have to manually contact all the different staff members to ensure that everyone involved is aware of the delay and then possibly scramble to find a viable alternative.
However, if you use an intelligent operating room allocation tool with real-time updates, this process becomes easy to automate, with notifications sent to all relevant healthcare staff at the right time. Implementing a digital patient tracking tool has also been found to improve patient throughput and identify cases that are running longer than scheduled, allowing the subsequent cases to be more to other rooms if available.
6. Reduce non-operative time between surgeries.
A minute of OR time is estimated to cost $62, and every minute when the OR is non-operative can be considered a financial loss, as well as a source of significant frustration to staff and patients. Therefore, when considering how to improve operating room efficiency, healthcare providers need to consider how to maximize the use of the OR without affecting the quality of patient care or the overall patient experience.
Researchers at the Case School of Medicine in Ohio were able to significantly reduce NOT by “minimizing nonoperative tasks in the OR, effecting parallel performance of activities, and reducing nonclinical disruptions.” To improve parallel processing, it may be necessary to add staff to help conduct procedures in tandem or add additional spaces to each surgical procedure. For instance, using an anesthesia induction room will allow staff to anesthetize the patient while the OR is being prepared by other personnel.
Handling complex processes in parallel requires meticulous scheduling and real-time communication. Switching from a manual, paper-based scheduling system to a surgery scheduling software will help you ensure that everyone is in the right place at the right time, with the right equipment available.
Build More Efficient Processes
When it comes to how to improve operating room efficiency, building more efficient processes for scheduling surgeries and communicating with healthcare personnel and patients is essential. Poor scheduling can result in first case start delays, excessive non-operative time, bottlenecks and delays, surgical case cancellations, and a lower quality of patient care. Implementing a sophisticated surgery scheduling software will allow you to automate and optimize your communication with both staff and patients, analyze historical data to identify opportunities for improvement, reduce delays and cancellations, estimate surgery time more accurately, and deal with the unexpected with more agility.
CaseCTRL is an AI-powered surgical scheduling solution that can help your OR handle more procedures efficiently. To find out more about how we help you harness artificial intelligence and automation to improve and accelerate surgical care delivery, please click here to schedule a live demo.