Lexington Medical Center has successfully navigated common challenges with OR block utilization, which is often present in the acute care setting.
Block time constraints and staffing challenges have led to our OR operating below the capacity needed to support our growing organization. We were intentional in our efforts to solve this problem by using actionable data to align our surgeons, leadership, and staff.
Utilizing the right data analytics and AI-powered technology, we’ve built trust among our stakeholders and created a culture focused on impactful change management. Through this transformation, we have increased our operational efficiencies, better utilized our resources, and begun unlocking the full potential of our ORs.
So far, we have achieved an 8% increase in case volume, an 11% increase in block utilization, and a 3% increase in prime time utilization. In addition, we have leveraged the data to smooth elective surgical volume across the days of the week while also creating the capacity to accommodate new surgeons. Just as important, we have also built the foundation to navigate future challenges with a sustainable model to achieve long-term success.
Lexington Medical Center’s scope and impact
Located in West Columbia, South Carolina, Lexington Medical Center is a locally owned, independent, and not-for-profit teaching hospital one of the few in the U.S. We are proud to be the number one hospital in our metro region, as rated by U.S. News and World Report, and the number two hospital in South Carolina. Between our main 607-bed campus and three ambulatory surgery centers, we have 45 ORs and performed more than 38,000 surgeries in 2023.
Why Lexington Medical Center needed to change OR utilization
In the past, surgeons often felt they did not have enough block time; however, we typically saw our block utilization average around 60%. Automated block release times were only two days for most service lines, so our surgeons often lacked sufficient lead time to claim opened block time. Scheduling cases was also challenging, as surgeons’ offices made multiple phone calls to a scheduling office swamped with hundreds of calls per day.
Pre-COVID, we had very few staff vacancies. During the pandemic, we lost many staff to travel positions or other opportunities and emerged with a vacancy rate of roughly 20%. As a result, we began running fewer rooms than usual. Surgeons were reluctant to release block time they did not need, fearing there would not be enough open time to add cases. There was also concern about ensuring we had available block time for new surgeons and our ability to continue to increase our surgical volumes.
To foster a culture where OR access was assured, we needed to provide visibility into our data and standardized metrics that informed and engaged all our stakeholders. To motivate the organization to make better use of our valuable resources and understand how we could all collaborate to achieve that, we needed a data transformation.
Creating a data-driven culture to drive efficiency in the Lexington Medical Center OR
In 2021, we partnered with AI software and services company LeanTaaS to deploy their iQueue for Operating Rooms solution. Support from the LeanTaaS change management team combined with an ongoing focus on building trust and enhancing collaboration with our administrative and surgeon leaders elevated our ability to identify and act on opportunities to improve OR efficiency and utilization.
iQueue provides a “single source of truth” of instantly accessible OR data that is easily displayed as metrics relevant to our leadership and surgeons. All stakeholders, including surgeons, can access the iQueue platform via the web or their mobile device and receive automatic weekly metrics updates on case volume, block utilization and turnover time. Our team can also access this information real-time while we’re meeting with practice leaders and surgeons, rather than having to manually find data or rely on anecdotal evidence or subjective perceptions.
Access to clear, accurate data fosters honest and objective conversations, builds trust and buy-in among our stakeholders, and demonstrates the universal benefits of improving OR efficiency. This empowered us to work together to create change.
Leveraging technology tools to transform OR utilization
The tools iQueue offers have supported our teams’ goal to improve OR utilization, opening access for more cases to be performed with existing rooms and staff. We have adjusted the parameters of these tools to match our block allocation policies and use the actionable metrics iQueue provides to continue making adjustments as needed.
iQueue reveals “Collectible” unused block time that is repurposable for cases, provides surgeons a platform to easily reserve time for cases and release time they do not need and sends automated release reminders based on individual surgeon’s past behavior and likely upcoming time needs. iQueue also provides recommendations to allocate more block time to service lines or surgeons who are growing their volumes over time and provides accurate predictions for daily case volume. We use iQueue to adjust block assignments, room scheduling, and staff assignments to create access for upcoming cases much more efficiently than using our EHR alone.
Lexington Medical Center’s success, results, and plans for the future
Our journey with our LeanTaaS partners has been ongoing for almost three years. We view it as a marathon rather than a sprint. We are always learning more about our OR, engaging our leaders and surgeons in the data so we can plan for the future and continue to grow.
Meanwhile, our cultural transformation and action-oriented tools have produced clear results. Based on our scheduling lead time data, we have been able to set block release times at five days for most service lines and ten for some, leaving more time for other surgeons to access unused time. Automated release reminders have resulted in a 137% increase in this time being released. Surgeons now see that they have access to enough OR time making them more comfortable releasing time they do not need.
In addition to our increase in case volume, block time utilization, and prime time utilization across all locations, case minutes have increased by 5%, and total block utilization for our main OR is at 71%. In the past year we have added 18 surgeons, accommodating block time for all of them without adding additional resources or physical ORs. Our metrics also demonstrate that we have capacity to accommodate future growth. To meet the needs of our community, our organization continues to grow and we are actively recruiting across all specialties.
The support from LeanTaaS has been excellent. The iQueue team has become a true partner, helping to analyze data, make recommendations, and ask critical questions about how we use their tool and manage our OR resources. We value this relationship and look forward to what we can do.
At Lexington Medical Center, we know there is much more we can do, and many more ways to optimize the OR, but we’re very happy with what we’ve accomplished so far.
See Lexington Medical Center’s 2023 discussion of their OR optimization journey here.