Leading health systems are taking innovative approaches and leveraging technology to address operating room staffing challenges exacerbated during the COVID-19 pandemic.
During a February webinar hosted by Becker's Hospital Review and sponsored by LeanTaaS, health system leaders described their most significant OR-related challenges and shared innovative approaches to solving these challenges. Panelists were:
- Sara Hubbard, principal consultant, operational performance improvement, Baptist Health (Jacksonville, Fla.)
- Kristen Lund, manager, preoperative medicine clinic, OR scheduling, MSPU scheduling, Oregon Health and Science University (Portland)
- Ashley Walsh, vice president, client services, iQueue for Operating Rooms and iQueue for Inpatient Beds, LeanTaaS
Five key takeaways:
1. Current OR staffing challenges have been exacerbated during the pandemic. Challenges include staffing shortages, increased costs associated with these shortages — because of overtime, increased use of travelers and more spending on recruiting and retention — and more of a struggle than normal to match OR staff and resources with demand for OR time because of backlogs.
2. Electronic scheduling is the foundation of OR optimization, transparently providing visibility into the backlog. Baptist Health schedulers now complete their entire surgical scheduling process on one platform. This platform provides accurate, up-to-date information on the case backlog, which has been critical as COVID-19 surges required OR rescheduling. This standardized approach streamlined processes and facilitated OR staff flexibility. The tool "not only improved our workflow, it eliminated a lot of workforce staff," Ms. Hubbard said. An automated in-app messaging feature puts accurate, timely information in the hands of schedulers, even as information changes rapidly, reducing errors.
Baptist's results show the value of leveraging technology to improve workflows and optimize staff. Primetime OR utilization improved nearly 40 percent since adopting the iQueue tool in fiscal year 2019. Gains continued during the pandemic, with a 6 percentage point increase in PTU from the first quarter of fiscal year 2021 to the first quarter of fiscal year 2022 .
3. Flexible room management allows a precise response to OR capacity management. OHSU's flexible room management is based on clear admission tiers that correspond to the block schedule. "Using new tools allowed us to have predictability in this chaotic time," Ms. Lund said. Clear parameters are communicated effectively, so schedulers' requests through iQueue maintain a high approval rating. Capacity can be managed up or down dynamically, with precision to avoid unnecessary scale-downs. The capacity module tool provides visibility, sharing accurate information across the system. Physicians from each service rotate as surgical triage officers to handle urgent cases.
4. Improving the accuracy of case length predictions, based on data, leads to better utilization of staff and surgeons. "For anesthesia and nursing staff, as OR use fluctuates, having cases that are not booked accurately has been a huge challenge," Ms. Lund said. The case length accuracy tool uses data to improve case-length prediction accuracy. Data is shared with surgeons and staff to improve their visibility into case length predictions and results. Surgeons are less likely to feel singled out when brought objective data and will then work to improve their results.
5. LeanTaas is a partner in improving OR efficiency. As OR leaders navigate these challenging times, LeanTaas' backlog calculator is a free tool to help ORs better understand their backlog. It has the ability to isolate specific service lines or times. It enables the modeling of changes to work hours on surgical volumes to ameliorate the backlog.
iQueue for the Operating Room is the comprehensive OR management system used by Baptist and OHSU that powers dynamic adjustments, automates processes and improves efficiencies. Its modules provide the ability to analyze data, giving users a single source of truth and metrics for decision-making.
Visibility into the backlog, communications, flexible room management and improved predictability represent effective new approaches to addressing OR staffing challenges.
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