Operating rooms are a major financial pressure point for hospitals. Minor gaps in standardization, scheduling inefficiencies, or a lack of trust in EMR (Electronic Medical Records) data can quickly escalate and ripple system-wide, affecting utilization, creating staffing confusion, and ultimately impacting an organization’s bottom line.

Dr. Chad Mathis, CMO at UofL Health-Louisville, discussed with Healthcare Innovation how the health system implemented system-wide OR standardization, centralized scheduling, and a single data source to drive higher value across 59 operating rooms.

Some highlights of the case study included:

• The team saw a 4 percent increase in YoY case volume growth (more than 400 additional cases) and a 3 percent increase in primetime utilization.
• With more efficient blocks/releases, the system recaptured 517,875 minutes and saved $1.5M in monthly anesthesia costs.

Mathis explains that the implementation of the changes was prompted by inconsistencies across scheduling mechanisms and the need for a centralized system. “The biggest thing,” he says, “was we really weren’t trusting our data as it came out of our EMR, because there were inconsistent ways that we were measuring things at each location.”

The health system partnered with LeanTaaS to standardize its ORs using the iQueue system. It then centralized its OR scheduling team. The team worked with its IT partners and LeanTaaS to create a standardized booking form. A steering committee of representatives from across the organization was formed to define parameters such as prime-time utilization, turnover time, and more.

Mathis says real improvements were observed in volume and turnover times. Anesthesia locums were reduced. “We made a conscious decision to decrease locums’ coverage, which was an exorbitant expense between the anesthesiologists and the CRNAs….Then we were able to maximize our block utilization.”

“Once we changed the block structure, people started buying into the new system,” Mathis continues, “they were able to release their time, and once they released their time, then other doctors could come in and refill the rate….Once those blocks are released, people are coming back into the operating room and finding time to book their cases that they couldn't get otherwise.”

Admittedly, Mathis notes that there were initial concerns among doctors. Mathis says the steering committee helped work through those concerns. Doctors can be very protective of their block time, and Mathis expresses that he was a little surprised by how long it took to work with the doctors to get them to buy into the new system.

Looking ahead, UofL Health continues to refine its approach. “We look at utilization, adjust our blocks based on utilization, and talk to the surgeons to make sure they have access to their data,” Mathis shares. “We continue our governance with our steering committee, making sure that we're doing the right things.”

Mathis recommends that healthcare leaders considering such a change should engage surgeons, IT staff, and vendors; consult their CEO; maintain transparency; and establish a steering committee.

“Our CEO, Dr. Smith, started the project when he was the CMO for the health system, and he's continued to be engaged with it,” Mathis remarks. “Having that type of leadership and partnership really is key to making this work.”