Smart and simple process changes help cut case times and costs
Most perioperative leaders are concerned about turnover time. And rightly so—lengthy turnovers squander expensive OR minutes. The typical surgery department, however, gives less attention to case time. Many OR directors view case time as a lower priority that is largely out of their control. This is a mistake. Prolonged case…
Restructuring and revamping workflow help a small hospital make big strides
Working for a small facility after spending many years at a large one can present a host of leadership challenges, but meeting those challenges with process changes and improved efficiencies can be highly satisfying. After serving more than 23 years at the Cedar Crest campus of Lehigh Valley Health Network…
Formula for successful cost control includes hard data plus surgeon champion
With decreasing Medicare reimbursements and increasing pressure to reduce costs, OR leaders everywhere are looking for creative solutions to balance their budgets. At Thomas Jefferson University Hospital (TJUH) in Philadelphia, standardizing surgical mesh looked like a way to save a bundle, and indeed a $1.5 million savings over a 3-year…
Firm policies and the right procedures tip the cost-benefit balance toward flip rooms
We spoke recently with surgery department leaders at an academic medical center in the Midwest. One of their biggest concerns was a challenge faced by many ORs today: “Flip rooms are just killing us.” Most surgeons prefer the efficiency and revenue potential of a flip room schedule. But for hospitals,…
Learning from Leaning: Case cart readiness improves after barriers are removed
Bristol Hospital had a supply problem. Instruments were often missing from case carts, so nurses had to scramble to find the items on the morning of a scheduled procedure. Staff wondered whether the problem was caused by shortages, but a Lean process revealed an entirely different scenario and forged a…
Multiple OR multidisciplinary team huddles promote ownership of process improvements
Huddles are hot. Experts cite them as effective patient safety tools, and many hospitals have implemented them on nursing units at the start of the shift. The perioperative services team at Vanderbilt University Medical Center in Nashville, Tennessee, broadened the huddle concept to include several disciplines and a structured format,…
Competency matrix modeled on ski trail difficulty validates staff skills at Vail center
Surgeon concerns about staff competency and high turnover of surgical technologists at Vail Valley Medical Center (VVMC), Vail, Colorado, prompted the development of a staffing skills competency matrix. VVMC is a community hospital with 4 rooms in its main OR, 4 rooms in its adjoining surgery center, and 4 rooms…
Tracking tool streamlines scheduling, enhances communication with surgeons' offices
Sacred Heart Medical Center RiverBend in Springfield, Oregon, began OR optimization efforts soon after moving to a new facility in August 2008. Because of the US economic downturn around that same time, the hospital launched several initiatives to make the most of available resources, including a Lean process to improve…
Improving instrument readiness cuts case delays, boosts surgeon satisfaction
Surgical case delays have been found to last an average of nearly 17 minutes. Not only do such delays make surgeons dissatisfied, they also reduce case volume and related revenues, and they may lead to additional time under anesthesia for patients. The root causes of instrument-based delays are seldom simple,…
Changes in nurses' pay structure solve staffing and scheduling problems
Many OR directors struggle with designing effective nurse compensation systems. The ideal system would achieve department goals while maintaining nurse satisfaction. Unfortunately, a compensation plan that links these 2 objectives is often elusive. In 2012, OR leadership at a small Pennsylvania hospital developed a compensation system that effectively aligns nursing…
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