Countdown to OR Manager Conference: Creative staffing models to increase surgical case volume within a fixed footprint

Editor's Note

MD Anderson Cancer Center shared insights on overcoming OR capacity challenges during a session at last year’s OR Manager Conference that highlighted creative solutions to staffing shortages and capacity constraints. With the ongoing pressures exacerbated by COVID-19, which is hitting a peak this summer, MD Anderson has implemented several strategies to optimize their perioperative operations, focusing on efficiency, staff retention, and patient care.

Speakers Mark Clemens, MD, associate vice president of perioperative services, and Elizabeth Ninan, MBA, PA-C, AVP of procedures and therapeutics, at MD Anderson Cancer Center highlighted:

• Creative staffing models: MD Anderson implemented a “rectangularization” strategy, extending OR hours and cross-training staff to cover multiple specialties, which improved OR utilization from 13 rooms in the afternoon to 22. They emphasized the importance of adjusting staffing ratios based on the complexity of cases.
• Capacity optimization: The team tackled capacity constraints by broadening the use of specialty rooms and load leveling across departments. They also implemented Saturday surgeries to increase throughput.
• Artificial intelligence (AI) and technology utilization: MD Anderson leveraged AI to optimize scheduling and improve case length accuracy, resulting in a significant increase in OR utilization and case volume. They also utilized existing electronic health record functionalities to enhance scheduling efficiency.
• Procedure redirection: A key focus was identifying low-complexity procedures that could be safely moved out of the OR to procedural suites, freeing up OR capacity for more complex cases.
• Stakeholder engagement: The success of these initiatives was heavily reliant on multidisciplinary collaboration and clear communication with all stakeholders, ensuring buy-in and effective implementation of changes.
• Professionalism and staff retention: Addressing professionalism in the OR through initiatives like the Vanderbilt professionalism model helped reduce turnover rates, creating a more positive work environment and improving staff retention.
• Sustainable practices: The session underscored the importance of sustainable practices in staffing and operations to prevent burnout, especially when operating at high utilization rates.

One significant initiative expanded on was the introduction of Saturday surgeries. Traditionally reserved for emergency cases, elective Saturday surgeries were expanded during the pandemic to better manage patient volumes and provide more timely care. This was particularly beneficial for local patients, who previously faced longer wait times due to competition with non-regional patients. By carefully selecting the types of cases suitable for Saturday procedures, MD Anderson maintained the same staffing ratios as during the week, ensuring consistent care while increasing OR utilization.

This MD Anderson’s experience shows the importance of innovative thinking, technological integration, and multidisciplinary collaboration in addressing staffing challenges still plaguing perioperative services. Look for new sessions tackling innovative staffing solutions at this year’s OR Manager Conference in Las Vegas, October 28–30.