Becker’s Hospital Review recently spoke with Dr. Joel Shaw, Vice President of Clinical Affairs at OhioHealth’s Grant Medical Center in Columbus, Ohio, on Grant’s use of AI-driven solutions to transform OR management practices, increasing both block and prime time utilization.
OhioHealth is a not-for-profit healthcare system that features 15 hospitals and 200+ ORs across central Ohio. As the busiest Level I Trauma Center in the Midwest, OhioHealth’s Grant Medical Center hosts nearly 8,000 trauma visits a year. Dr. Shaw presented on this topic in depth at Transform Hospital Operations Virtual Summit on December 10.
Question: Can you tell us about the environment at OhioHealth’s Grant Medical Center?
Dr. Joel Shaw: We’re the only downtown hospital in Columbus, Ohio, and we’re most known as a surgical hospital. You can imagine that being a busy trauma center means that we’re an extremely busy surgical center. As such, surgical operations are really important to Grant’s overall work. We have two main OR centers: 18 rooms at the main campus, and 10 more across the street used mainly for ambulatory cases.
Q: What sort of challenges did you see in your OR operations, and how did your perioperative transformation begin?
JS: Before embarking on our transformation journey, we were facing several operational challenges. One was with underutilized block time. When surgeons went on vacation but retained their scheduled block time, operating rooms were left unused. This resulted in reduced patient access and underutilized staff, while other surgeons experienced delays in scheduling their cases despite available OR capacity. And with 80% of our block time already filled, onboarding new surgeons and giving them time was difficult.
We also saw opportunities to unify our case scheduling practices between our employed and private practice physicians. About 65% of our physicians are employed by OhioHealth, while 35% bring surgeries to us through their private practices. Private physicians, in particular, were not well integrated into our scheduling process because their outpatient practices used different electronic health records. Too often when we try solutions, they work better for one group than the other, which doesn't make a great medical staff culture.
Another challenge was with data. We have a lot of data, but it doesn't always contain explanations or show us the ways to solve the problem, and you really have to use it correctly or risk losing people along the way. An example of this could be found with our case length predictions. If you say a case is going to be an hour and a half, but it actually takes two and a half hours, there are downstream effects for every case starting after it. Inaccurate predictions resulted in overtime for staff and inefficient utilization of their time and a poor patient experience.
These challenges and others led us to seek out not just an AI-based solution to analyze data and provide optimizations, but a partner that could help us implement the solution and drive real system-wide transformation.
Q: There are a lot of moving parts in this sort of work. How did you get everyone on board, and what results have you seen thus far?
JS: To start, we partnered with LeanTaaS to begin looking at our past data and patterns, building the storytelling of allocation and optimization, and showing the opportunities to our surgeons in a way that’s impactful to them. For example, they were surprised to learn that 23% of our block time was going unused.
In my mind, it was all about communication: the buy-in of staff and surgeons, and then visibility to the surgeons on where the improvements would be. And once we were live with iQueue for Operating Rooms, LeanTaaS’ AI-powered capacity optimization solution, the capabilities were just what we needed—not just the reports that showed progress, but automated notifications to surgeons showing opportunities to add and drop block time, right on their mobile phones.
The initial results happened quickly. In our first full year, we saw a 3% increase in case volume, and a 56% reduction in entire blocks going unused.
And we continue to see improvement. This year, we achieved an 11% increase in block utilization and a 7% increase in prime time utilization versus last year. And most importantly, with 38% of surgeons’ released time being filled, more patients have access to get the treatment they need sooner.
Q: Aside from the improvements in block and prime time utilization, what other benefits did you and OhioHealth see?
JS: Before we implemented these new optimization tools, our block committee meetings were highly political and largely tactical. We were often stuck talking about issues with block utilization without any real solutions. Once we shifted the focus to block optimization and brought in data-driven tools, everything changed. Now, we’re having higher-level conversations about where we are growing and what’s next. For example, we’ve been able to strategically grow priority areas like thoracics, urology, and orthopedics, while decanting other procedures, such as pain management and podiatry, to facilities that are better suited for those cases. This shift has allowed us to align our OR strategy with the hospital’s overall goals and make much better use of our resources.
Another area was in case length predictions, which I mentioned previously as a persistent issue. We were underestimating our case times, and this would cause a ripple effect that led to cases getting bumped, poor patient experience and staff overtime. This is really where LeanTaaS got shoulder-to-shoulder with us and worked with our surgeons, meeting face-to-face to show case length predictions and what true optimization can look like. And over the next three months, we actually saw an increase in cases for the orthopedic surgeons by optimizing block time instead of adding block time.
Q: Were there challenges with change management and rolling out these new processes with staff? How did you overcome them?
JS: The communication piece I mentioned was a challenge to overcome. When we did establish that trust, our governance meetings became more strategic. Having a partner willing to dig in with us and pull the surgeons along into the conversation is really what we needed to be able to move through changes and be successful.
We implemented iQueue in October, one of the busiest times of the year as surgeons were trying to maximize cases before year-end deductibles reset. Understandably, there was concern about fitting in all their cases, but LeanTaaS held multiple meetings with our team and surgeons, and adjusted processes to ensure cases were scheduled. Within six weeks, we optimized block time and increased orthopedic cases without adding new blocks. This quick win turned skeptics into champions and demonstrated the tool’s value right away, building trust for future success.
I think the biggest key to success in implementing a new data-driven solution was meeting the surgeons where they were, adjusting on the fly as we were standing things up, and showing them that AI- and algorithmically-based optimization really works.
—
Dr. Shaw’s session, titled “Transforming OR Efficiency at OhioHealth Grant Medical Center: Leveraging AI to Achieve an 11% Increase in Block Utilization and a 7% Jump in Prime Time Utilization,” took place on December 10, 2024, at Transform Hospital Operations Virtual Summit. Watch it now on demand.