Duke University Hospital has had a Pre-Operative Screening Unit (POSU) in place for the past 16 years to optimize patients prior to surgery, but until recently, there were no hard data on surgical cancellation rates. Now, a retrospective analysis has revealed that fewer cancellations occur when patients are seen in…

Read More

Changes in staff responsibilities and greater collaboration have contributed to dramatically improved first-case on-time starts at the University of Louisville Hospital, Louisville, Kentucky—from about 35% to 86% in a little over a year. Turnover time has been reduced, too, with slow but steady progress suggesting that revamping existing structures can…

Read More

OR Business Performance is a series intended to help OR managers and directors improve the success of their business.   How do you improve an OR’s financial performance? Last month’s column focused on two key strategies: using data to identify improvement opportunities and rallying support for organizational change. These strategies…

Read More

Productivity monitoring and management are near the top of the priority list for every perioperative nursing director. With 50% to 80% of a hospital’s costs in labor, staffing dollars are a big target for cost management. Some experts say hospitals and health systems will face budget cuts of 20% to…

Read More

First of 3 articles on applying Lean management to turnover time. Sinai Hospital of Baltimore faced a challenge. The block schedule was maxed out, even though new ORs had been added. There was a need to eke out every available minute. Despite efforts to improve turnover time, it had plateaued…

Read More

Second of 3 articles on applying Lean management to turnover time.   Efforts to weed waste from turnover time quickly took root in one 10-OR department. Within about a month after OR staff and certified registered nurse anesthetists (CRNAs) embraced the new process, turnover time decreased from about 26 minutes…

Read More

Third of 3 articles on applying Lean management to turnover time.   Creating a “visual workplace” is a principle in Lean management. Visual cues have been one solution for improving turnover time at Thomas Jefferson University Hospital in Philadelphia. In a visual workplace, the goal is to make waste, problems,…

Read More

Lean management in a teaching hospital’s otolaryngology OR improved efficiency, morale, and finances in a study from the University of Michigan (U-M), Ann Arbor. After 18 months: • turnover time (from exit of one patient to arrival of the next) fell by nearly one-third to 29 minutes • turnaround time…

Read More

With hospitals under ever greater economic pressure, perioperative managers are expected to hew closely to staffing productivity targets, meaning they must match staffing as closely as possible to the hours of surgery actually performed. They’re also expected to grow surgical volume. Hospitals’ revenue depends on it. To grow volume, ORs…

Read More

When Providence Sacred Heart Medical Center and Children’s Hospital in Spokane, Washington, decided to tackle waste and inefficiencies in its 4,400 square-foot-case cart and sterile supply room, leaders set modest goals for improvement: increase case picking productivity by 4% and relocate enough items to create 6 carts of space for…

Read More