COVID-19 created a massive disruption for elective surgeries, which are a critical piece of health systems' revenue stream.
In 2020, elective surgeries were postponed, and then waves of patients produced a historic backlog.
During an October webinar hosted by Becker's Hospital Review and sponsored by LeanTaaS, presenters from LeanTaaS — Ashley Walsh, vice president of client services, and Zetong Li, senior director of product management — discussed best practices and solutions for reducing the elective surgery backlog.
Five takeaways:
1. Identify your real surgical capacity. This involves looking carefully at operating room constraints and searching for opportunities to create capacity. Constraints might include staffing, the nature of block scheduling, and the inpatient population, which may mean a patient doesn't have a bed post-surgery.
Health systems, forced to rethink OR scheduling and utilization because of the pandemic, have come up with solutions to increase OR open time. Examples include moving up time for automatic block release, encouraging use of ambulatory surgery centers for procedures that don't have to be in the main OR, and extending OR hours carefully, in a way that may reduce overtime.
2. Rethink the block schedule. Maximizing utilization of blocks is critical. Many hospitals LeanTaaS is working with have been able to quickly and effectively adjust their block schedules.
Also, physician practices need to see when they have unfilled block time as well as how to request, release and find additional block time. "If we don't make it easy for our providers, it's going to be very challenging to increase the optimization that we even have in our capacity," Ms. Walsh said.
3. Have visibility into your backlog. Organizations need to capture backlog information and provide visibility of this data. Communication of this information is key, because departmental communication and integration will help unlock capacity. For example, creating frequent "huddles" between teams can facilitate communication about patients who could be transferred or released earlier.
Part of the communication needs to include checking on staff morale. "If you're going to make changes to those hours, if you're going to change your block schedule, I'm checking with the team to see what the temperature is," Ms. Walsh said.
4. Continuously monitor the backlog. The backlog of elective surgeries should be cataloged and analyzed. For example, how big is it and where is it coming from? It may need to include information such as urgency and priority, using standardized metrics for consistency.
That sort of lens helps review and assign available time to surgeons with the highest-priority cases. "When there is an executive order, or some kind of decision made that they are going to postpone elective cases, they have a clear prioritized list," Mr. Li said.
5. Assess your need for tools to help. LeanTaaS, a predictive analytics company that uses AI and machine learning to help hospitals use their scarce assets more effectively, offers free resources in addition to its proprietary platform. These resources include an Excel-based backlog template and an online backlog calculator.
Among the more than 110 health systems using LeanTaaS products are New York City-based NewYork-Presbyterian, Charlotte, N.C.-based Novant Health, and Tacoma, Wash.-based MultiCare. Focusing on eliminating their post-pandemic backlog has forced these heath systems to run their ORs more efficiently. LeanTaaS has helped these and other organizations achieve impressive results, including a 6 percent increase in case volume as well as increased prime time and block utilization.
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