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

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

Nov 12, 2023 186 likes •374 views

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 Childrens Hospitals

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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

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

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PRESENTERS

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

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  • 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

Joan Estes, RN, BSN, MS

  • 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
  • rganizational structures, throughput analysis, data analysis and special projects

Brian Mullahey, BA, MBA

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OBJECTIVES

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

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  • 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
  • pportunities to remedy the issue(s)
  • Ensure the keys to success are in place

Learning Objectives

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  • 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

Areas of Focus

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  • 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

Success Drivers

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OPERATING ROOM EFFICIENCY: UTILIZATION

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

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Operating Room Utilization

  • 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

Calculation Methodology

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Operating Room Utilization

  • 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

Utilization Efficiency Goals

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Example Overall OR Utilization Data Analysis

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Example Primetime OR Utilization Data Analysis

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

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

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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

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Physician/Group 3rd Qtr YTD Assign Hrs Hrs Used 3rd Qtr Util 3rd Qtr Actual Util w Downtime

O1 WED 58% 51%

90 32.95 36.6% 38.8%

CARE1 WED 70% 69%

90 45 50.0% 53.3%

OPER01 WED 42% 44%

114 10 8.8% 1.8%

ETT4 WED 86% 95%

114 35.3 31.0% 35.8%

IN01 1/3 WED 79% 81%

27 19.75 73.1% 71.3%

ORT10 WED 78% 76%

90 52.75 58.6% 71.9%

A3A WED 84% 86%

147 54.45 37.0% 42.8%

A3D WED 90% 89%

114 50 43.9% 49.6%

ORTH14 WED 18% 34%

54 19.5 36.1% 31.5%

SUR08 WED 78% 76%

90 53.75 59.7% 76.9%

ORTH2 WED 86% 95%

114 86 75.4% 91.2%

EN15 WED 64% 81%

114 83.1 72.9% 91.3%

ORTH08 2ND WED 86% 52%

28.5 18.5 64.9% 74.6%

OL01 WED 65% 67%

90 43.25 48.1% 49.7%

R02 WED 42% 42%

84 25.8 30.7% 31.9%

03 WED 64% 65%

90 27.5 30.6% 30.6% WEDNESDAY

SOYRING VALIDATION OF BLOCK UTILIZATION

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Example OR Block Data Analysis vs Rooms Open Utilization

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0.0% 20.0% 40.0% 60.0% 80.0% 100.0% 120.0% Monday Util w Downtime Tuesday Util w Downtime Wednesday Util w Downtime Thursday Util w Downtime Friday Util w Downtime Overall

Medical Center OR: Block Utilization vs Room Utilization

Blocked time Block Utilziation Room Utilization Utilization Target