Finding a balance between access and productivity can get complicated. If you don’t have enough access in the OR, other hospitals will have a competitive advantage. If you over-staff to ensure access, you will fall short on productivity targets.
Sullivan did a consulting engagement for a hospital concerned about the following issues:
- The perioperative staff was leaving to work at nearby hospitals
- Volume was dropping and surgeons were taking their cases elsewhere
- Everyone was unhappy
After a bit of investigation, it was clear that the hospital was suffering from unrealistic productivity targets. The CEO was demanding that the OR never say no to an add-on case. The CFO was demanding a productivity target of 105 percent. The pressure to meet the target was forcing the OR to send people home early. The demand to accommodate the surgeons was forcing those who remained to work overtime to get the add-on cases done.
The Sullivan To-Do List:
- Reset utilization. Our review indicated that in order to meet the goal of never saying no to cases, daytime utilization could not exceed 60 percent.
- Recalculate productivity. Productivity was recalculated using the new utilization target: 4.2 worked hours of surgery at 85 percent utilization became 5.5 worked hours per hour of surgery at 60 percent utilization.
- Redefine blocks. The redefinition of block requirements for surgeons incentivized the surgeons to fill their blocks and opened up time for those who weren’t serious about filling it.
- 90 percent or more utilization – no release time
- 75-90 percent – three-day release
- 50-75 percent – five-day release
- Less than 50 percent – removed block
Within six months, the annualized volume increased by 1,200 cases. Staff turnover went down. Sick time went from 22 percent of paid hours to 14 percent of paid hours. The Hospital created a vast amount of open time from the dropped blocks with 25 percent of the elective hours deemed as open time.
No two ORs are exactly the same, which makes comparing productivity targets arbitrary. You have to understand how you are different. Fix the ineffiencies you can and adjust for those you can’t. You have to be flexible, thorough and specific to generate the appropriate productivity target for your hospital.
If you’re struggling with productivity, Sullivan can help. Contact our team to discuss a confidential proposal.