The OR at a Midwestern Hospital was a constant logjam.
Surgeons were often unable to get on the schedule. Though this was their preferred hospital, surgeons would sometimes have to operate in other facilities, because they couldn’t be accommodated. The OR had a generalist nursing model, so surgery teams were always different. Surgeons wanted consistency. The current model meant multiple schedule changes and add-ons – every day. Efficiency needed improvement. Facility leaders wanted future growth and an increase in patient volume, but without changes, that couldn’t happen.
The facility’s OR Director said, “We felt our block utilization was not where it should have been. We felt we were losing efficiency and wanted to better strategize.”
Sullivan Health Care Consulting was brought in for a surgery program assessment and implementation assistance. Bill Bailey was the primary SHC consultant and project director. “We restructured their governance and some staffing,” Bailey said. “We recruited and coached new medical directors and set up a perioperative executive committee.”
One big change was in OR scheduling. As SHC examined policies and procedures with a scheduling committee, the block model was closely scrutinized. “Basically, the OR Manager and I were handling all of the day-to-day operational concerns, from surgeons to staff,” said the OR Director. “Our OR was extremely busy and this was overwhelming.” The Sullivan team developed pods, which defined space and teams specific to service lines. The results: surgeons were now more likely to stay in the same space with the same team. They are more satisfied and their patients get procedures done in a more timely way.
Another significant difference was in patient throughput. In developing the pods, SHC hired assistant clinical managers – ACMs – to help coordinate OR activities. “With the new structure, the ACMs are the go-to people for the service line,” the OR Director explained. “The staff has moved under these new individuals as well. This has removed a bit of the chaos.” Bringing in a consultant can be nerve-racking for leaders of a facility. They know their hospital needs changes, but can they trust hiring an outside firm to bring about the necessary transformation? With Sullivan Healthcare Consultants, the answer is a resounding “yes.” The OR Director reported: “We had a great experience with all the consultants. They were high-standard, very knowledgeable and really helped us.” SHC confirmed the OR’s challenges, and it was validating for the perioperative team to have a third party validate those concerns. As a result, that increased their credibility with hospital leadership.
Specifically, the OR Director said Bailey, as the lead consultant, made a big difference. “His personality – the way that he’s dealt with docs, staff, presentation and the way his communication works – made our staff comfortable and we were able to push through a lot of stuff we wouldn’t have if someone else had been leading the project.”
Bailey’s recommendation to add four ACMs was a key organizational structure improvement. “That really has helped with communication, distribution of workload [and] job satisfaction. The management team and staff now have a go-to person,” the OR Director said.
The surgery Medical Director recently updated the surgeon advisory council on the status of the project. His highlights: block utilization has gone way up; surgeons are happier; surgeon access has improved; new recruits and staff are generally happier; and retention is improving. There’s a new level of expectation.
A big test is whether, upon reflection, hospital leaders would hire Sullivan again. The OR Business Manager answered that question: “Definitely. We actually recommended Sullivan to another hospital… We’re Sullivan fans.”