My Surgery Scheduler has COVID. Now what?

What is your business continuity plan? If your scheduler contracts COVID, how do you ensure that your revenue engine does not come to a grinding halt? As we navigate the COVID crisis administrators are struggling to keep the ship afloat. Many realized after the initial wave of shutdowns that closing business altogether is not a sustainable strategy. Continuity plans must account for ever changing government mandates, personnel and resource constraints, and an uneasy public. Historically many surgeons have relied on a singular surgical scheduler. This can be problematic for a number of reasons, but particularly so during a pandemic. Below we describe 4 tactics to reduce your reliance on one scheduler and ways to eliminate the "surgeon silos".

Create Collaborative Workflows

The fastest way to unlock a surgeon's workflow is by creating a collaborative process for surgical scheduling. At many institutions surgical schedulers maintain their own internal lists of pending surgeries. In our current climate, where surgery schedules are changing by the week, it is more important than ever before to keep an accurate log of surgical candidates. To ensure business is not interrupted if a scheduler becomes ill or unavailable, it is important to maintain these lists in some shared format. At the simplest level, this could mean a shared spreadsheet or other electronic roster. Creating a central repository for storing this vital information makes it easier for anyone to take over if necessary. Given that these sheets will contain valuable protected health information, be sure to follow HIPAA compliant practices. You may find some EMRs have a features for surgical scheduling and sharing. In our experience, these solutions are often cumbersome and static repositories of this information. Be sure your schedulers are updating the data in the EMR to accurately reflect your pending surgical candidates

Promote Transparency and Accountability

A surgeon's biggest fear when adding multiple parties to the scheduling process is zero responsibility for hang ups or missteps.

The second step to cultivating a collaborative surgical scheduling process is creating accountability. A surgeon's biggest fear when adding multiple parties to the scheduling process is zero responsibility for hang ups or missteps. There can be as many as 46+ steps and 150+ data points (trust us-- we analyzed it!) to communicate in order to successfully schedule a surgery. To implement a collaborative workflow, there must be zero confusion about what elements of the scheduling process are pending, and who is taking responsibility for completing them. Even if only one person is primarily scheduling a surgeon, when this is all mapped in one central place, everyone can suddenly see where bottlenecks are, and personnel resources can be allocated to alleviate such hold ups. Furthermore, expertise can be sharpened, and specialized teams can be developed for rate-limiting items such as insurance pre-authorization. No two surgical practices are the same, and each surgical sub-specialty has its share of challenges, therefore any strategy you deploy must be flexible and account for each surgeon's nuances. We recommend creating a shared dashboard for monitoring case scheduling progress. Creating one that integrates into the existing workflow and automatically updates progress can instantly supercharge any surgical practice.

Be Proactive, Not Reactive

During this pandemic, surgical scheduling can be unpredictable. Not only are resources in a constant state of flux, but patients are scared and unsure about the safety of proceeding with elective surgeries. Rather than reacting to forthcoming mandates and leaving patients second guessing, we prescribe a proactive approach that recognizes local trends and resource availability. For patients, create unified messaging that imparts confidence and reassurance. Don't rely on individual schedulers at the last minute to come up with their own strategies. All surgical candidates should be informed about measures implemented to foster safer operating practices. Testing and cleaning protocols should be explicit. Furthermore, as resources become scarce or hospital beds get filled, recognize which cases are most at risk, and prioritize cases accordingly. Having a mechanism to easily stratify patients according to their intended post operative admission plan can allow you to nimbly navigate changing local conditions.

Enable Virtual Surgical Scheduling

The typical surgery scheduling paradigm is not very conducive to remote working. If your practice relies on paper posting sheets, or forms to schedule surgeries, remote working can be virtually impossible (no pun intended) when surgeons and schedulers are physically apart.

So you have made it this far and implemented all the strategies to allow for a nimble surgical practice. But how do you replace that asymptomatic scheduler with COVID that has worked for 15 years with your highest volume surgeon that is suddenly forced into self-quarantine? How will you ensure that the surgeon's practice marches forward without a hitch? Even with a collaborative scheduling dashboard to transfer the work, replacing productivity of lost personnel can be difficult. The typical surgery scheduling paradigm is not very conducive to remote working. If your practice relies on paper posting sheets, or forms to schedule surgeries, remote working can be virtually impossible (no pun intended) when surgeons and schedulers are physically apart. Secure mechanisms for transmitting and communicating this information with schedulers at home must be organized beforehand. Secure access to existing EMRs and shared spreadsheets must also be implemented.