A 12-hospital system with over 25,000 employees and more than 3 million patient encounters a year needed to improve operating room (OR) utilization and efficiency. Impact
Advisors partnered with the organization to conduct a Surgical Services and Supply Chain assessment, followed by implementation of identified improvements across both areas. There were four overarching goals of the engagement:
- Maximize the health system’s surgical capacity.
- Optimize hospital and surgery center operations to better support efficiencies throughout the surgical space.
- Increase satisfaction and engagement among surgeons and patients.
- Improve supply chain and inventory management.
“There’s been a 360-degree change in the provider experience over the course of the engagement.”
Key Levers to Improve Operating Room Utilization and Efficiency
Before the partnership with Impact Advisors, the health system struggled with OR utilization and efficiency. From a Surgical Services optimization perspective, data transparency and accuracy challenges abounded. Dashboards lacked standardization and were perceived as being unreliable. Meetings involving stakeholders were disorganized, lacking formal agendas and a solid decision-making structure. On the supply chain management side, processes were highly manual and inefficient. There was no inventory management system, and non-standardized preference cards were prevalent.
To strengthen Surgical Services leadership and management, Impact Advisors established OR Collaboration Committees (ORCCs). These committees, which meet monthly to present and discuss operational improvements, include key decisionmakers from Surgery, Anesthesia, and Nursing. Cultivating a culture of peer-to-peer accountability is a major goal of these meetings, which is why Impact Advisors facilitated the establishment of operational and block subcommittees to drive daily changes within the ORs. The
work of these subcommittees played a pivotal role in the success of the ORCC throughout the engagement, as they were directly responsible for implementing multiple successful pilot initiatives, many of which were expanded to other service lines.
To promote operational excellence and improve foundational processes related to OR scheduling, Impact Advisors created a new block allocation system that assigned OR time more democratically. The team worked closely with organization leadership to implement strict standards around requesting and managing OR blocks. Establishing
system-wide standardized targets for turnover time and utilization was critical.
Impact Advisors also created Surgical Services par-level locations within Peoplesoft to optimize supply chain and materials management, working with Supply Chain, Corporate, and IT stakeholders as well as hospital end-users. The team also developed and implemented a standardized preference card maintenance process across service lines and facilities, ensuring that all preference cards are consistent regardless of the facility where the surgeon is credentialed.
Positive Impact
The engagement was successful across all objectives. Multiple Surgical Services and hospital leaders said that the block scheduling allocation process developed by Impact
Advisors was the most “efficient,” “fair,” “productive,” and “beneficial” system that they had been part of. Furthermore, the peer-to-peer accountability process that Impact Advisors implemented across Nursing, Anesthesia, and Surgery teams through the ORCCs was repeatedly praised by hospital executives. One commented, “There’s been a 360-degree change in the provider experience over the course of the engagement.”
Nearly all operations subcommittee pilots, across multiple specialties, had positive results that fostered a culture of accountability and collaboration among internal teams.
For example:
- First Case On Time Starts (FCOTS) increased by 16% over 6 months for one of the flagship hospitals, the largest increase during this period for the entire system by double digits.
- Reduced Turnover Time (TOT) to under 40 minutes (compared to a baseline of 60+ minutes) in 13 of 20 eligible OR vascular surgery cases through focused coordination among Anesthesia, Nursing, and Surgical leadership. In terms of tangible improvements within Supply Chain Management, the team’s efforts resulted in a 37% reduction across locations in Proposed Par Under Management.