LeanTaaS’ iQueue for Operating Rooms

Jan. 23, 2020
Using predictive and prescriptive analytics to unlock OR capacity and create a more surgeon-centric process for measuring utilization

iQueue for Operating Rooms (ORs) represents a significant opportunity to improve prime time utilization (PTU) of operating rooms. ORs are one of the most valuable assets within a health system by virtue of their contribution to the revenue and operating margins of the entire health system. Yet, there are significant structural problems in the way that the OR block scheduled is allocated and managed which leads to their under-utilization including: Individual surgeons and service lines have an extremely volatile pattern of the number of minutes of OR time that they use from week to week.

Yet, most health systems allocate the blocks of OR time in a relatively static manner (i.e., Dr. X has a full-day block on Monday and Thursday or orthopedics get two blocks of OR time every day of the week). Most health systems use a flawed metric (block utilization) to make decisions on the number of blocks that should be awarded (or taken away) from surgeons and service lines. Block utilization is a gross average that penalizes surgeons for small, fragmented chunks of time (room turnover, first case on-time starts, etc.) that are often beyond the surgeon’s control and cannot be usefully repurposed into scheduling an additional case.

Further, it does not account for the inherent volatility in case lengths across surgeons and service lines which makes any relative comparison of block utilization numbers inherently flawed from a mathematical perspective Most health systems have a manual, labor-intensive, error-prone process for surgeons and service lines to release blocks that they no longer need or to request an additional block of OR time to schedule surgical procedures. The process involves phone calls, text messages, emails, voicemails, faxes, Post-It notes and drop-by visits to consummate these “transactions.”

The net result is clearly visible; blocks of OR time are often left unused even while surgeons who would have valued the opportunity to squeeze in some additional cases are forced to push them out to subsequent days or weeks. Most health systems have difficulty in accessing performance data in a timely and convenient manner. Standard reports of block and room utilization, on-time starts, turnovers etc. are extracted from the EHR and assembled into PDFs for all surgeons and service lines and distributed via email.

Often, the definition of the key metrics is unclear, there are disagreements about the accuracy of the numbers and the reports are not really effective in driving actionable change iQueue for Operating Rooms automatically receives data feeds from the EHR and dramatically improves the utilization of operating rooms by:

  • Enabling a “marketplace” for surgeons and service-lines to request and release open time in the operating room from their mobile device or desktop Optimizing the allocation of block time to surgeons and service lines based on intelligent algorithms
  • Providing detailed, timely and accurate visibility of the key metrics of operating rooms through mobile “push” and web “pull” so the right surgeon and administrator has the right information at the right time to make fact-based decisions.

iQueue for Operating Rooms is built around three modules as follows:

Exchange: identifies and exposes inventory of open time to surgeons and clinics needing OR time through an “OpenTable for Open Time” like tool. Surgeons and clinics can easily discover and request time with one click from any mobile or desktop browser. The module shows clinics’ and surgeons’ open time on the grid for six months into the future. It monitors booking patterns to identify blocks that are likely to be underutilized and sends reminders to surgeons and schedulers to proactively release them.

Analyze: Monitors OR performance to help surgeons and administrators get a single source of truth with metrics and KPIs that are credible, well-defined and understood. It helps surgeons and clinics be more proactive and productive by sending timely mobile alerts that tell them how they are contributing to OR volumes, how their performance metrics are trending, and ways to improve their utilization.

Collect: Mines patterns of OR usage by block owner, surgeon, and service line to identify truly “repurpose-able” portions of time—also called “collectable time”—and provides actionable guidance about “collecting” underutilized blocks without impacting existing case volume. Collected blocks can be reallocated to new or existing surgeons needing more time, or to run fewer ORs. iQueue for Operating Rooms improves PTU by 4 to 6 percentage points, resulting in a financial impact of ~$500,000 per OR per year.

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