Goldilocks and the Three ORs: Right-sizing Your OR To Be Just Right - PowerPoint PPT Presentation

Goldilocks and the Three ORs: Right-sizing Your OR To Be Just Right Joan Estes, RN, BSN, MS Clinical Consultant Brian Mullahey, BA Manager Perioperative Services Administrative Support Rhode Island & Hasbro Children’s Hospitals

Goldilocks and the Three ORs: Rightsizing Your OR to Be Just Right 2

Goldilocks and the Three ORs: Rightsizing Your OR to Be Just Right PRESENTERS 3

Joan Estes, RN, BSN, MS • Currently responsible for Project Management including Implementation Assistance • 25+ years of nursing leadership and consulting experience • Managed all of the Perioperative Services departments including Main OR, Sterile Processing department, and Materials/Purchasing • Extensive experience in the areas of Surgical Services strategic planning, change management, leadership and staff development, case cart system implementation, and regulatory compliance • Experience working in various settings ranging from small rural hospitals to large metropolitan teaching centers of excellence Brian Mullahey, BA, MBA • Currently responsible for administration and non-clinical operations of Perioperative services including financial analysis and planning, staff scheduling, block scheduling, cost management, charge capture, materials utilization management and computerized systems • Strong background in organizational design, premium labor management, staffing, scheduling, and process improvement including lean, six sigma, and customer satisfaction delivery systems • Management and consulting experience including consolidation and streamlining of organizational structures, throughput analysis, data analysis and special projects 4

Goldilocks and the Three ORs: Rightsizing Your OR to Be Just Right OBJECTIVES 5

Learning Objectives • Understand what it means to “right-size” your OR in order to realize improved efficiency and cost savings • Identify causes of “wrong-sized” ORs and opportunities to remedy the issue(s) • Ensure the keys to success are in place 6

Areas of Focus • Understanding utilization management to match supply to demand (“rightsizing your OR to be just right”) • Data collection and analysis • Policies and Procedures • Surgeon input and communication • Identifying common issues impacting OR efficiency • Case study • Actionable steps to “right-size” and keys to success 7

Success Drivers • Data collection accuracy and data analysis • Mutually aligned success goals between physicians, hospital administration and perioperative services staff(s) • Operational efficiencies • Fiscal stewardship • Continuous process improvements 8

Goldilocks and the Three ORs: Rightsizing Your OR to Be Just Right OPERATING ROOM EFFICIENCY: UTILIZATION 9

Operating Room Utilization Calculation Methodology • Overall: Hours/minutes of surgical cases completed during elective schedule time divided by hours/minutes OR staffed open for cases to be scheduled into = utilization percent • Block: Total hours/minutes cases completed by assigned surgeon/specialty within their block compared to amount of time blocked for that surgeon/specialty = utilization percent 10

Operating Room Utilization Utilization Efficiency Goals • Overall and Block: 75% if excluding turnover time, 80% including turnover time • Less than 60% - poor • 70% - good • 80% - optimum • Greater than 85% - consider opening more elective schedule time to improve surgeon access to OR schedule 11

Example Overall OR Utilization Data Analysis 12

Example Primetime OR Utilization Data Analysis 13

Example OR Utilization Data Analysis by Time Segment Based on # Rooms Open in that Time Segment 14

Example OR Utilization Data Analysis by Time Segment Each Day of Week Based on # Rooms Open in that Time Segment 15

Example OR Block Data Analysis vs. Rooms Open Utilization Block Utilization analysis revealed that hospital allowed too short release time for • most of specialties. To demonstrate benefit of varying release time, Soyring Team analyzed Block Utilization without release time and compared it to Room Utilization WEDNESDAY SOYRING VALIDATION OF BLOCK UTILIZATION 0.5 Physician/Group 3rd Qtr YTD Assign Hrs Hrs Used 3rd Qtr Util 3rd Qtr Actual Util w Downtime 90 32.95 36.6% 38.8% O1 WED 58% 51% 90 45 50.0% 53.3% CARE1 WED 70% 69% 114 10 8.8% 1.8% OPER01 WED 42% 44% 114 35.3 31.0% 35.8% ETT4 WED 86% 95% 27 19.75 73.1% 71.3% IN01 1/3 WED 79% 81% 90 52.75 58.6% 71.9% ORT10 WED 78% 76% 147 54.45 37.0% 42.8% A3A WED 84% 86% 114 50 43.9% 49.6% A3D WED 90% 89% 54 19.5 36.1% 31.5% ORTH14 WED 18% 34% 90 53.75 59.7% 76.9% SUR08 WED 78% 76% 114 86 75.4% 91.2% ORTH2 WED 86% 95% 114 83.1 72.9% 91.3% EN15 WED 64% 81% 28.5 18.5 64.9% 74.6% ORTH08 2ND WED 86% 52% 90 43.25 48.1% 49.7% OL01 WED 65% 67% 84 25.8 30.7% 31.9% R02 WED 42% 42% 90 27.5 30.6% 30.6% 03 WED 64% 65% 16

Example OR Block Data Analysis vs Rooms Open Utilization Medical Center OR: Block Utilization vs Room Utilization 120.0% 100.0% 80.0% 60.0% 40.0% 20.0% 0.0% Monday Util w Tuesday Util w Wednesday Util w Thursday Util w Friday Util w Downtime Overall Downtime Downtime Downtime Downtime Blocked time Block Utilziation Room Utilization Utilization Target 17