Based in Washington State, the 11-hospital MultiCare Health System consists of 1,800 providers and 20,000 employees.
Mary Bridge Children’s Hospital is located in MultiCare’s Tacoma campus. Silje Kennedy, MSN, MBA, RN, Director of Perioperative Services at MultiCare, discusses the unique setting of Mary Bridge Children’s, the changes the system is currently undergoing, and how pediatric surgeons and staff have been empowered to optimize their case schedules both before and during a time of transition.
Question: What distinguishes Mary Bridge Children’s, both as a pediatric facility and within the MultiCare system? How would you describe the perioperative space in particular?
Silje Kennedy: Like many pediatric facilities, Mary Bridge Children’s is efficiently run and oriented to the patients’ needs. We consider all the same metrics that we would for an adult operating room like length of stay, block utilization, first case on time starts and turn over time. Most pediatric perioperative cases are outpatient, so volume moves through quickly. We are also prepared to care for much higher acuity pediatric inpatient cases to include cardiothoracic, major general and urological procedures and pediatric spine correction utilizing robotic technology.
While the children’s OR continues to share geography with the adult OR, we are currently also building a new standalone children’s hospital building on the MultiCare campus. Outpatient rooms are being demolished and rebuilt. Scheduling block time has become more complicated for surgeons, especially as some service lines must relocate during construction while others must continue to perform cases in the main operating room.
Q: Why did Mary Bridge Children’s adopt an analytics-based system for scheduling cases and OR time?
SK: For the past four years, the Mary Bridge Children’s OR team has used a scheduling platform built on data analytics, which allows schedulers and surgeons to easily release and reserve open OR time. The need for this tool may not have been obvious initially, as most of our pediatric block time did not auto release and we already prioritized working through case volume efficiently. But pediatric providers still had to schedule time in an OR that was shared with other providers, and we needed to recruit and retain surgeons at Mary Bridge Children’s. The solution, which offered a clear and simple exchange of OR time, improved scheduling and delivered an experience that attracted, engaged, and rewarded surgeon and staff users.
Q: Can you describe the “buy-in” journey for surgeons and staff adopting and embracing the new system?
SK: Adopting any new system or tool is a challenge, especially for providers who may not feel they need further support. In our case, surgeons quickly realized the tool delivered exactly what they wanted and needed in their work, which of course encouraged them to adopt and use it. For instance, the tool showed utilization metrics for each surgeon and service line. Mary Bridge Children’s surgeons have high standards for themselves and their colleagues, so seeing the metrics drove these providers to continually improve them. The tool provided both the metrics themselves and the best, most effective opportunities to act on them.
Users could also see how scheduling cases through the tool opened more capacity quickly. The administrative process was streamlined, and smaller units of time, not enough to be releasable blocks by themselves, were made available for short cases like dental or ophthalmological procedures so they could be scheduled more quickly. Since these simpler cases comprise most of the pediatric OR, utilization increased in a measurable way and left further room for more complex cases like tumor removals to be performed during prime time hours. Using the tool overall drove greater staff and provider satisfaction, leading to further engagement and championing of it.
Q: What results have you seen from the use of the platform? What has the impact been on clinicians, staff, and patients and families?
SK: Surgeons are now able to schedule cases in their desired place and time. This is helping support the transition as we change our physical OR space, and we’re continuing to see strong prime time utilization.
In the past, longer add-on cases would need to be accommodated in the late evening or the middle of the night. Now surgeons and schedulers make much more efficient use of daylight hours. Not only does this increase provider and staff satisfaction, but it supports better outcomes for patients and their families. Patient wait times have been reduced overall. Routine patients can go home and recover sooner, while those who need emergency or last-minute procedures can be scheduled immediately. The results are clearly positive, reducing stress and supporting healing for all involved.
Q: What advice would you have for pediatric hospitals, and especially perioperative spaces, undergoing similar challenges to Mary Bridge Children’s?
SK: I would advise pediatric and perioperative leaders to be truly aware of what their surgeons and staff are undergoing. We should understand not only their day-to-day challenges, but what motivates and encourages them in their work. In Mary Bridge Children’s case, our surgeons and staff embraced a new solution because it aligned so well with their existing goals, namely in better serving patients and excelling in their utilization metrics. This led to them solving and addressing challenges they may not have even previously realized they had.