Widespread staffing shortages, especially among anesthesia providers, are posing significant challenges to operating room efficiency. But some hospitals and health systems are leveraging timely information about procedure schedules, patient flow and OR turnover to maximize both OR utilization and staff satisfaction.
To learn more about how minute-by-minute coordination systems are helping healthcare leaders streamline work for clinical teams and drive greater OR efficiency, Becker's Healthcare recently spoke with Tony G. Kim, MD, Associate Professor of Anesthesiology with Baylor College of Medicine and the Director of Special Projects in the Anesthesiology Department at Houston-based Baylor St. Luke's Medical Center.
OR efficiency depends on visibility into personnel and case status
Identifying where staff are and determining case status are perennial issues of managing any OR.
"I remember the days when we used magnetic strips to track surgeries," Dr. Kim said. "It was extremely difficult because you had no sense of how long cases were taking — some might go longer and others shorter."
Tracking personnel is particularly challenging in multi-site facilities, where staff are working in disparate campuses and running their own schedules. Knowing where people are is critical if cases need to be shifted to accommodate add-on and emergency cases that arise. Visibility into case status is also essential so anesthesiologists and surgeons can arrive in the right place at the right time.
To address these issues, Baylor St. Luke's Medical Center deployed ORControlTM. This minute-by-minute coordination tool automates and organizes hospital procedures, putting physicians, anesthesiologists, OR staff and other groups on the same page. The result is greater staff and facility efficiency.
The organization deployed ORControl after implementing Epic. Since the two systems are integrated, clinicians and other staff can access real-time information about OR activity. "I can track where personnel are and when cases are closing, then utilize our human resources as efficiently as possible," Dr. Kim said. "That was missing in the past. ORControl is like air traffic control for operating rooms. The reality is that unexpected things will arise that affect OR capacity, but you have the ability to manage them."
ORControl provides a running timeline in a Gantt chart-like format, which displays the duration of cases and how OR capacity is utilized through the day. Users can filter data to view OR information in different ways.
"I can look at just the main operating rooms, the main endoscopy area or all the ancillary areas where anesthesia provides services in the main hospital," Dr. Kim said. "The filtering functionality allows us to see things from many different perspectives, which is very helpful."
ORControl improves the provider and employee experience
At Baylor St. Luke's Medical Center, ORControl helps anesthesiologists and surgeons to maximize their productivity. Providers receive texts from ORControl indicating when patients hit different milestones, such as arriving in the holding area or moving to the OR. Those notifications enable clinicians to complete other tasks while patients are in transit or aren't yet ready for bedside care.
"With ORControl, I don't have to keep going back to the holding area to see if the patient is there," Dr. Kim said. "It's been a big improvement in efficiency in terms of my ability to multitask and do other things. That's been true for our surgical colleagues as well, who often round on the floor or attend to tasks while waiting for patients to arrive in the operating room. It's a huge time saver."
ORControl also provides visibility into when certified registered nurse anesthetists and certified anesthesiologist assistants are scheduled to take breaks, go to lunch, and end their shift. Tracking that information with a single, visual piece of software has created a better work environment at Baylor St. Luke's Medical Center.
"The workforce is very appreciative of the fact that we make sure they get their breaks and lunch," Dr. Kim said.
Greater visibility into OR schedules translates into optimal asset and staff utilization
One of the biggest challenges in developing an OR staffing model is determining the most efficient utilization of resources. The goal is to fill ORs as much as possible, while leaving space for add-on cases and surgeons who don't operate at the institution all the time. Matching staff skill sets to cases is also very important.
"When our leadership works on the schedule on a daily basis, it's a conversation between anesthesia leadership and nursing leadership to ensure that operating rooms are appropriately staffed and ready to go," Dr. Kim said. "ORControl is very helpful because it shows gaps in the schedule where we can potentially move things around to create capacity. Sometimes, it looks like a gigantic Tetris board as we try to fit in everything as maximally as possible."
To monitor OR efficiency, Baylor St. Luke's Medical Center uses ORControl to track key performance indicators like first case on time starts, room turnover rates and more.
Technology can transform OR efficiency, but finding the right partnership is essential
To understand what a minute-by-minute coordination tool like ORControl can do, it's helpful to visit a facility that's already using the solution. "Seeing ORControl in use shows how sophisticated the software can be. Notice what things you might want to customize to accommodate your workflows," Dr. Kim said.
For example, Baylor St. Luke's Medical Center worked with Healthcare Control Systems to highlight in ORControl whether newly added cases are stat, emergent, urgent, or semi-elective. Now when add-on cases happen, the right classification is clearly visible, and everyone knows the urgency of the case.
"Healthcare Control Systems has been incredibly responsive to our needs," Dr. Kim said. "There is a dedicated person who is very familiar with our hospital operations, and I have a point person I can reach out to with questions. Many times, I have sent a text to the representative because we had to get new staff into ORControl quickly. Within 24 hours or less, it was done. That kind of responsiveness is pretty amazing."
With ORControl, Baylor St. Luke's Medical Center enjoys greater efficiency in its ORs, as well as in other departments that use anesthesia. Since operations are no longer a black box, the organization can maximize utilization of both human resources and physical assets.
"Given the shortage of anesthesia personnel across the country, we don't have the capacity to open up more operating rooms," Dr. Kim said. "ORControl has allowed us to use the people we have with maximal efficiency."