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…
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,…
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…
ASCs part of the new face of healthcare
With fewer new ambulatory surgery centers (ASCs) forming each year and more merging back into hospitals, it has become popular to describe the industry as “mature.” It’s not yet time for an obituary, however. Improved technology, bolstered by healthcare reform, is driving a transition to outpatient treatment, and, when it…
First case on-time starts soar after rapid process improvement training
In 2011, fewer than half of all first cases at Dartmouth Hitchcock Medical Center in Lebanon, New Hampshire, were starting on time. That meant subsequent cases were also delayed, with overtime costs exceeding $500,000 a year. “People were unhappy with that for a lot of different reasons. It was a…
Surgical team familiarity reduces operative time, improves performance
Surgical team familiarity contributes to reductions in operative time, and performance improves as team experience accumulates, a new study finds. Previous studies of teamwork and its influence on surgical outcomes have been limited by the challenge of objectively quantifying teamwork. Survey-based methodologies are subject to responder bias, and the tools…
Collaboration and creative thinking hold down the number of OR holds
Putting a hold on the OR can lead to revenue losses no manager wants to see. At Lehigh Valley Health Network (LVHN) in Allentown, Pennsylvania, OR holds were averaging 1,100 minutes per month. Jodi Koch, BSN, RN, director of perioperative services, and Kathleen Duckworth, RN, CPAN, their colleagues got holds…
Using Lean strategies to improve operating room efficiency
Improvements in first case on-time starts and turnover time at Lancaster General Hospital in Lancaster, Pennsylvania, attest to the success of using Lean strategies. Within an 8-month period, first-case on-time starts (FCOTS) jumped from 35% to 72%, and the monthly average overall turnover time (TOT) for a 7-month period was…
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