In a webinar hosted by Stryker Performance Solutions on June 17, Richard Conn, MD, co-medical director; Greg Wheat, vice president, service line development; Marita Parks, RN, program manager, operating room optimization; and Cathy Jerow, RN, program manager, performance solutions at Stryker Performance Solutions, discussed key focus areas to improve operating room efficiency and profitability.
"The OR is one of the most costly areas of a hospital," said Dr. Conn. "And stakeholders are looking for ways to impact efficiency and drive down OR costs."
Here are five key areas to focus on to optimize OR processes and improve efficiency:
1. Effective OR leadership. According to Mr. Wheat, the ideal OR leadership team should include physician champions, namely the surgeon and anesthesiologist, as well as a strong OR director. However, it is important that administrators and OR directors appear approachable. "I would advise OR directors and administrators, however, to wear scrubs when coming to the OR," he says. "Don't come in a suit. In scrubs, you are much more approachable and accessible to the surgeons and staff members."
Ms. Parks adds that for an OR leadership team to be effective they need to work collaboratively, be engaged in OR processes and also have a clear mission and goals.
2. Surgeon engagement. Providing accurate, relevant and timely data to surgeons is key to keeping them engaged. It is essential to ensure that the OR data given to surgeons is credible. "OR directors sometimes provide surgeons with data that is not timely and surgeons find holes in it. Then you lose their attention," says Mr. Wheat.
Another strategy for keeping surgeons engaged is carving out the time to talk to them outside the OR about any changes they would like to see or suggestions they have for improvement in the OR. "Also check-in with them periodically and let them know what you are doing about what they said," he says. "They need to know that they are being heard."
3. Maximize OR efficiency. The most common issue that leads to inefficiency in the OR is not starting the first case of the day on time, according to Ms. Jerow. "You spend the day playing catch-up if you start the first case late," she says.
It is vital to look at first case start times and shine a light on the issue. OR directors should gather those numbers, highlight the areas causing delays and then present that data to surgeons, says Mr. Wheat. Also, OR directors need to ensure there is trust between the surgeon and OR staff. "You also have to work at getting surgeons and staff past the trust issue," he says. "Oftentimes the OR staff isn't ready because they think the surgeon isn't ready, and the surgeon hasn't come in because he or she thinks the staff isn't ready."
Another aspect affecting OR efficiency is turnover times. Having a standardized room set-up can go a long way in ensuring quick room turnovers. "That way, when the staff and surgeon enter the room, everything is on-hand," says Ms. Jerow.
4. OR procedural profitability. One of the most effective methods for controlling OR costs, and thereby improving profitability, is letting surgeons know how much each procedure costs. "The single best way to get surgeons on board with cost containment policies is to show them the costs," says Mr. Wheat. "Most have no idea how high the costs are."
According to Ms. Parks, supply standardization in the OR is another important aspect of cost containment. "Examine physician preference cards to reduce variability and standardize supplies," she says. "Looking closely at preference cards is essential when looking to drive profitability in the OR."
5. Culture of safety. Now that the healthcare industry as a whole is shifting to value-based reimbursement, it is important that organizations hardwire patient safety practices in the OR setting and reduce variability, says Ms. Parks.
"Having a huddle the day before surgery is a great way to ensure that the surgery goes smoothly," she says. "The entire team should meet the day before the procedure and resolve any issues that may affect patient outcome."
Patient safety and patient satisfaction should be the highest priority in the operating room, adds Dr. Conn, and that will lead to efficient and profitable ORs.
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