A range of variables feed into operating room efficiency, such as nursing, staffing, time distribution and supplies — just to name a few. Surgical staff, hospital administrators and physicians play different roles in each piece, which can often result in fragmentation, competing priorities and an OR resistant to change. As a result, opportunities for improving quality, safety, efficiency and costs may not be fully realized. ORs that integrate problem-solving skills through a multidisciplinary team can tackle each of these pieces of the puzzle, leading to reduced costs, increased satisfaction and improved throughput.
Manoj Pawar, MD, vice president of clinical operations and physician leadership development for Denver-based Catholic Health Initiatives, advises hospital leaders to consider the following steps to achieve a culture of change within the hospital OR. A well-designed OR vision committee or strategy team can modify components of the OR to create change that is wide-reaching and backed by each discipline, including technicians, nurses, physicians and administrators.
1. Identify the governing structure in place. Dr. Pawar recommends hospital leaders first ask whether the organizational structure for overseeing the OR is adequate. Many times, hospitals may examine the structure more closely and realize it is not serving the OR's needs or does not include representation from key stakeholders or disciplines. Other times, multiple structures may exist separately, with no single structure fully accountable for the entire value stream as it relates to the OR. "Sometimes, the right participants aren't involved," says Dr. Pawar, who notes the structure should be multi-disciplinary, including representation from nursing, administration, technicians and physicians from multiple specialties.
2. Focus on making the team multi-dimensional. Hospital COOs or CEOs can help create the governance design to ensure the proper participants are involved. "It's important this committee or team be co-led," says Dr. Pawar. Physician, nurse or administrator co-leadership models help break down barriers within each discipline. For instance, it can be difficult for valuable ideas from nurses to be implemented if they do not have a physician partner, and vice-versa. This is due to the fragmented nature of organizational communication within the department, as well as the autonomous culture of physicians.
3. Create shared visions and an environment welcoming of ideas. The committee needs to define its parameters, visions and shared expectations. Dr. Pawar has spent extensive time defining these objectives with previous OR committees. One of the worst things that can happen is committee members feeling as though this is a waste of time and their decisions will not be implemented in the OR. It's also vital that the committee thinks collectively rather than spar over resources. "If I'm a vascular surgeon or have specific causes I want to advocate, it's important to set those aside and look at the OR from what is in the best interest of the whole," says Dr. Pawar.
4. Facilitate healthy conversation and share results. It's key for co-leaders of the committee to be adept at facilitating healthy conversation. "Discuss the impacts and the benefits of proposed changes," says Dr. Pawar. For instance, if a department renegotiates its vendor contracts, it may save hundreds of thousands of dollars a month. "It's important for committee-members to know that this change actually translated into something," says Dr. Pawar. CFOs can ensure there is a feedback loop to explain how money is being saved or reinvested. "CFOs, senior management and senior leadership need to be involved," says Dr. Pawar, "but it has to be in partnership with physicians."
Related Articles on OR Efficiency:
6 Steps to Build of a "Culture of Safety" in the Hospital Operating Room
10 Proven Ways for Surgery Centers to Improve Workflow Processes
5 Strategies to Improve Patient Flow in a Busy Hospital
Manoj Pawar, MD, vice president of clinical operations and physician leadership development for Denver-based Catholic Health Initiatives, advises hospital leaders to consider the following steps to achieve a culture of change within the hospital OR. A well-designed OR vision committee or strategy team can modify components of the OR to create change that is wide-reaching and backed by each discipline, including technicians, nurses, physicians and administrators.
1. Identify the governing structure in place. Dr. Pawar recommends hospital leaders first ask whether the organizational structure for overseeing the OR is adequate. Many times, hospitals may examine the structure more closely and realize it is not serving the OR's needs or does not include representation from key stakeholders or disciplines. Other times, multiple structures may exist separately, with no single structure fully accountable for the entire value stream as it relates to the OR. "Sometimes, the right participants aren't involved," says Dr. Pawar, who notes the structure should be multi-disciplinary, including representation from nursing, administration, technicians and physicians from multiple specialties.
2. Focus on making the team multi-dimensional. Hospital COOs or CEOs can help create the governance design to ensure the proper participants are involved. "It's important this committee or team be co-led," says Dr. Pawar. Physician, nurse or administrator co-leadership models help break down barriers within each discipline. For instance, it can be difficult for valuable ideas from nurses to be implemented if they do not have a physician partner, and vice-versa. This is due to the fragmented nature of organizational communication within the department, as well as the autonomous culture of physicians.
3. Create shared visions and an environment welcoming of ideas. The committee needs to define its parameters, visions and shared expectations. Dr. Pawar has spent extensive time defining these objectives with previous OR committees. One of the worst things that can happen is committee members feeling as though this is a waste of time and their decisions will not be implemented in the OR. It's also vital that the committee thinks collectively rather than spar over resources. "If I'm a vascular surgeon or have specific causes I want to advocate, it's important to set those aside and look at the OR from what is in the best interest of the whole," says Dr. Pawar.
4. Facilitate healthy conversation and share results. It's key for co-leaders of the committee to be adept at facilitating healthy conversation. "Discuss the impacts and the benefits of proposed changes," says Dr. Pawar. For instance, if a department renegotiates its vendor contracts, it may save hundreds of thousands of dollars a month. "It's important for committee-members to know that this change actually translated into something," says Dr. Pawar. CFOs can ensure there is a feedback loop to explain how money is being saved or reinvested. "CFOs, senior management and senior leadership need to be involved," says Dr. Pawar, "but it has to be in partnership with physicians."
Related Articles on OR Efficiency:
6 Steps to Build of a "Culture of Safety" in the Hospital Operating Room
10 Proven Ways for Surgery Centers to Improve Workflow Processes
5 Strategies to Improve Patient Flow in a Busy Hospital