As the Director of Perioperative Services at Good Samaritan Hospital, I believe that scheduling is the first step in assuring our patients' safety. The scheduling office plays a key role in confirming that all aspects of the surgery are accurately planned and documented, including:
- The correct specialty
- The specific procedure
- The necessary equipment
- The necessary personnel
- The correct incision point
When this information is not correctly entered into our system, several problems can occur. A surgery may be cancelled for lack of equipment, an improper block of time may be allotted, or the cascade effect from one inaccurately scheduled surgery may affect other surgeries throughout the day.
Good Samaritan Hospital already had McKesson OR Benchmarking in place, but initially we were not leveraging it to monitor our scheduling practices. Working with a McKesson Business Advisor, we ensured the integrity of the data put into ORBC. We then presented the data to surgeons and staff to highlight opportunities to drive continued scheduling accuracy, increase on-time starts, improve patient satisfaction and reduce overtime.
Trust in the data
Having accurate, live data to show physicians has been very persuasive. Whether we're talking about the average length of a specific procedure or chronic lateness, we can view this information with the click of a button and answer questions on the spot. When proposing changes to our scheduling procedures, our solutions are backed up with accessible, verifiable data. For example, a physician may rely on memory to guess how long a given procedure will take, but we have post-case data history to show the block of time actually needed.
Diving into the details helped identify seemingly small factors that could drive significant improvements. We found that a key detail for one of our highest volume procedures was often overlooked in scheduling. The time and equipment difference for an open or laparoscopic cholecystectomy is substantial, and an error either way could mean a delayed or cancelled procedure. We also discovered that late starts were sometimes caused when pre-op antibiotics were delivered to the inpatient unit rather than the operating room. Adjusting the delivery protocol minimized this reason for delay.
Once we began addressing some of the reasons for delay, we could also get a clearer picture of our operating room utilization and begin to align our resources with how our rooms are actually used. Drilling down into our weekend hours, for example, allowed us to begin researching the feasibility of scheduling staff for a regular 8-hour shift on Saturday rather than relying on unplanned callbacks throughout the weekend. This will be a cost savings for Good Samaritan and a benefit to staff.
Our accuracy metric continues to climb as we address the opportunities identified through ORBC, nearing a 20 percent improvement in the second quarter of 2015. In addition, we have cut casual overtime in the operating rooms to near zero, as staff no longer needs to stay late to get caught up. The increased efficiency in scheduling and planning has also allowed us to reduce patients' time in the pre-op area by 30 minutes, which provides a considerable increase in patient comfort and satisfaction.
To learn more about how Good Samaritan gained insights into their scheduling performance and assessed the downstream impact of scheduling on OR throughput, download our webinar, Benchmarking Drives OR Efficiencies and Savings, recorded September 2, 2015. Or, download the case study to see how Good Samaritan built trust in their data and used the findings to identify and address opportunities to enhance OR efficiency.