Operating rooms across the United States are on a constant quest to optimize their processes, cut costs while maintaining quality, and increase profits. In such a dynamic, high-stakes environment, success begins with strategic scheduling of surgeons, staff, anesthesiology, ancillary resources, and procedures. In other words, optimizing OR utilization is key.
According to recent studies, the modern OR is the economic engine of most hospitals, accounting for up to 60% of a hospital’s revenue and some 35‐40% of the hospital’s expenses. Over 60% of the hospital’s margin comes from surgical patients. Moreover, each empty but open OR suite may cost an estimated average of $1,000 per hour.
Some estimates report that ORs only achieve 50-60% utilization, representing a significant missed opportunity for revenue. Increasing OR utilization by just one percent can translate to hundreds of thousands of dollars in increased revenue for a facility with a single OR, or millions of dollars annually for a multi-OR surgical center or hospital.
Many organizations are improving utilization by implementing a block scheduling system.
What is Block Scheduling and How Does it Work in the OR?
Block schedule, simply stated, is dividing up the total coverage plan into blocks that are offered to specific surgeons or services as “dedicated” time for them to do their cases. This allows more efficient processes since the surgeon should be following themselves and most surgeons tend to schedule multiples of the same or similar procedures.
When the blocks are filled to 80% utilization or above, everything tends to work better. When most block models are sub-optimized it’s usually because of one of the following:
- Lack of clear block management rules and metrics
- Inability to govern the process, allowing the rules to go unenforced
- Fear of angering low volume surgeons resulting in high volume surgeon frustration
- No consideration for add-on/urgent/emergent volume
When blocks are well developed and managed it also allows the OR to offer electronic access for schedule requests directly to the surgeons offices, which has been shown to increase the share for surgeons that work in multiple sites.
How to Optimize Block Scheduling in the OR
The ultimate goal of block scheduling for OR support staff is to ensure a seamless operation; when the surgeon arrives, the staff, equipment, and patient info should be ready to go. In the most efficient surgical centers, the surgeon should feel like they are booking an appointment online — it’s fast and easy, and they are able to create their own routine by having predictable blocks of time reserved at the facility each week.
Here are factors to consider when implementing block scheduling:
1. Utilize Real-Time Data
Use real-time data to optimize which blocks should be available at which times and determine the resources and staff that will need to be utilized in each. Rather than standard block lengths, consider implementing variable blocks that can change based on each case. Each situation is different, so OR management should consider the following utilization factors when allocating blocks:
- OR capacity
- Organizational goals and mission
- Anesthesiology requirements
- Available resources (rooms, equipment, support teams, etc.)
- Flexibility for patient volume changes
Keep in mind that non-elective blocks should be scheduled before the elective ones, on a first-come, first-serve basis.
2. Prioritize Surgeons
A balance should be struck that properly ranks new surgeons, growing surgeons, and surgeons that see declines in revenue into prioritization categories. There is no one-size-fits-all solution to prioritization, since it will largely depend on factors unique to each healthcare facility. However, full day blocks should generally be reserved for surgeons with high accountability and utilization rates.
3. Keep Track of Real-Time Data and Adjust as Needed
To be most effective, the block scheduling model will probably require some fine-tuning when it is first implemented. A facility may find that they need to keep more blocks open for last-minute needs or emergent cases. They may also find that they need to create daytime add-on blocks to accommodate certain types of acute care without resorting to after-hours add-ons. All of this, and more, will be determined through consistent monitoring and tweaking in order to strike the right balance and optimize operating room workflows.
4. Establish a Governance Structure
Leaders from various departments, including but not limited to nursing, anesthesiology, and surgery should meet on a consistent, weekly basis to determine changes in individual block allocation as well as other scheduling needs, based on utilization data. A defined governance team is crucial to the continued success and adaptability of the OR block scheduling model.
Sullivan Healthcare Consulting Can Evaluate and Optimize Your OR
Our consultants have all had extensive careers as healthcare leaders in the perioperative space and we have a national perspective of what is working today in optimizing surgical services. We can help you create a customized, consistent block schedule that will enhance schedule accuracy, lower case costs, protect resource utilization, and increase the daily case rate.
Contact Sullivan Healthcare Consulting today to find out more!