Surgeons often have an adversarial relationship with data.
They question the accuracy and timeliness of data and are skeptical about trusting data. This lack of trust in data can affect important areas such as block utilization and first case on-time starts. By focusing on effective data governance and investing in technology, hospitals and health systems can experience significant benefits.
During a Becker's Hospital Review webinar sponsored by LeanTaaS, Rebecca Hartley, DNP, assistant vice president of surgery at Shannon Medical Center in San Angelo, Texas, described some of the challenges that this medical center faced, steps they took to address these challenges and results they have achieved, including increasing block utilization by 13 percent.
Shannon Medical Center is a Level III trauma facility that serves a 25-county region in West Texas. Named the top trauma facility in the state, Shannon Medical Center performs about 11,000 surgeries per year.
Three key takeaways were:
- Key challenges at Shannon Medical Center include lack of accurate data, an unpredictable surgery schedule and ineffective surgical governance. "We had a lack of access to accurate, timely data and surgeons didn't trust the data we did have," Dr. Hartley said. "In addition, some of our block utilization was as low as 10 percent, and we had an extremely unpredictable surgical schedule."
These challenges were compounded by a growing case volume coupled with many add-on surgeries, which meant that some physicians were working until 1:00 a.m. and were struggling with burnout. In addition, Shannon Medical Center struggled with its surgical governance, as every physician could be on the surgical governance committee, which tended to focus on complaints, not solutions.
- Shannon Medical Center built a more effective governance structure based on complete and accurate data insights using software from LeanTaaS. Shannon Medical Center sought to change its culture and its surgical governance structure, based on a foundation of trusted data. This involved achieving openness and transparency, creating effective collaboration and shifting to a performance orientation.
It also involved surgical division chiefs sharing data with their groups and creating clearly defined partnership goals. "Our surgeon leaders had to build trust with their teams and the administration," Dr. Hartley said. "We worked on clearly defined partnership goals, including optimizing OR time, improving block utilization and establishing a single source of truth," which was done through data.
- As a result of these efforts, Shannon Medical Center successfully reduced turnover times, increased first case on-time starts (FCOTS) and boosted block utilization. "Our surgical teams, including our nurses and techs, now have quarterly turnover time goals, which has decreased 10 percent," Dr. Hartley said.
FCOTS have increased by 19 percent, with increased engagement of surgeons. "We had one physician who had an FCOTS of 97 percent, which is great," she recalled. "But he really wanted to know which cases he did not start on time. We've developed this high level of engagement with our surgeons as a result."
Finally, block utilization has increased by 13 percent with proactive block release reminders and more comprehensive, real-time access to the schedule itself. "Schedulers from the surgeon's office can go in and access open time slots," Dr. Hartley said. "It's at their fingertips. We're also working with them to release their block in advance and are looking at those numbers at our monthly surgical leadership meetings."
In the future, Shannon Medical Center plans to continue to train clinical schedulers to unlock more access, educate surgeons on specific KPIs and scorecard usage and keep executive management informed with customized reports and emails.
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