In a typical hospital surgery department, each surgeon is assigned an OR and works a certain number of cases back to back separated by turnover time. At Shriners Hospital for Children in Boston, however, the scene is somewhat different: OR teams are assigned to each room except for one, which is used to prepare the patient scheduled in the subsequent time slot. When one surgeon finishes, he or she moves to the room with the next patient and immediately begins the procedure. Meanwhile, the OR team in the first room cleans and prepares for a new patient. On average, keeping one room empty for every four or five ORs will enable the department to use this parallel processing model, according to Jim Bowden, RN, MBA, perioperative services nurse manager at Shriners Hospital for Children. He likens parallel processing in the OR to musical chairs but with an extra "chair" instead of one less.
Parallel processing essentially eliminates turnover time for surgeons because they can begin working on the next patient in the other room immediately after finishing with the first patient. Shriners has been able to increase throughput by approximately 30 percent using this scheduling pattern, Mr. Bowden says. In addition, eliminating turnover time for physicians avoids additional delays because staff members do not have to find surgeons who may have used the time to see other patients or take a break outside the department, Mr. Bowden says. Parallel processing also benefits staff members because they aren't as rushed during turnover. "There's usually not as much panic or running around or rushing," he says.
This scheduling model does present some challenges, however. First, because OR teams are assigned to a specific room and surgeons move between them, staff members have to be skilled in a variety of procedures to accommodate each surgeon's case. Secondly, OR leaders need to gain the buy-in of surgeons and staff to shift from a traditional, sequential system to a new, parallel system of working. "The operating room is a very routine-oriented place," Mr. Bowden says. "Changing that routine usually meets some resistance." Mr. Bowden manages resistance by educating the physicians and staff on how the new model can benefit them. Surgeons benefit from added cases and no turnover time; staff members benefit from less pressure during turnover time and positive feedback from physicians who appreciate being able to move immediately from one case to another in a room that is already prepped. "Help people mentally grasp what [they will be] doing, and most of the time people are accepting," Mr. Bowden says.
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Parallel processing essentially eliminates turnover time for surgeons because they can begin working on the next patient in the other room immediately after finishing with the first patient. Shriners has been able to increase throughput by approximately 30 percent using this scheduling pattern, Mr. Bowden says. In addition, eliminating turnover time for physicians avoids additional delays because staff members do not have to find surgeons who may have used the time to see other patients or take a break outside the department, Mr. Bowden says. Parallel processing also benefits staff members because they aren't as rushed during turnover. "There's usually not as much panic or running around or rushing," he says.
This scheduling model does present some challenges, however. First, because OR teams are assigned to a specific room and surgeons move between them, staff members have to be skilled in a variety of procedures to accommodate each surgeon's case. Secondly, OR leaders need to gain the buy-in of surgeons and staff to shift from a traditional, sequential system to a new, parallel system of working. "The operating room is a very routine-oriented place," Mr. Bowden says. "Changing that routine usually meets some resistance." Mr. Bowden manages resistance by educating the physicians and staff on how the new model can benefit them. Surgeons benefit from added cases and no turnover time; staff members benefit from less pressure during turnover time and positive feedback from physicians who appreciate being able to move immediately from one case to another in a room that is already prepped. "Help people mentally grasp what [they will be] doing, and most of the time people are accepting," Mr. Bowden says.
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