Between the expanding population and the increasing number of surgical procedures being performed, demand for surgical services is climbing. One study has predicted a 14% to 47% increase in surgical demand across all surgical fields by 2020. Given the high cost of operations, an efficient workflow is paramount, and there…

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Accurate OR case scheduling is a key performance indicator that is challenging to manage. The published literature often focuses on scheduling algorithms using historical data, the surgeon’s own estimate, or a mix of similar procedures. This mathematical approach neglects the cultural, economic, behavioral, and process challenges that impact attempts to…

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Editor's Note The ECRI Institute has issued a white paper titled, “Responsive staffing and scheduling in aging services: A systems rethinking approach.” Problems in staffing and scheduling can lead to potentially dangerous conditions, which can cause performance gaps in delivery of care and services. To better address these problems, providers…

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Editor's Note Evaluation of patient age and American Society of Anesthesiologists (ASA) physical status as variables can help OR managers better predict turnaround times, which can facilitate scheduling, this study finds. Researchers developed models of turnaround times of 13, 632 OR procedures with respect to multiple variables including surgical schedule,…

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Recommendations emerging from a data analytics project have helped OR leaders at Vanderbilt University Medical Center in Nashville, Tennessee, better anticipate daily surgical case volume and share that information with their managers. Data gleaned from the project are now being used to predict staffing needs for the OR, anesthesia department,…

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Theoretical advantages exist for both block and nonblock scheduling. Facilities with enough space and staff may be able to schedule cases on the basis of patient and surgeon convenience, but that doesn’t work for facilities with less flexibility. At our facility, problems associated with first-come, first-served booking led to an…

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Turnover time and first case on-time starts are a common problem in most ORs, so leaders are always seeking ideas for improvement. OR Manager recently spoke with two leaders who have had remarkable success in each of these areas.   The Dartmouth-Hitchcock experience When the average turnover time (TOT) at…

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Editor's Note Simple changes in preadmission testing and OR scheduling, including appointing a senior nurse anesthetist to help direct OR use, resulted in improvements in OR efficiency and case volume in this study. Substantial improvement was seen in first case on-time starts (39% to 84%), as well as utilization of…

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Block scheduling can be one of the most contentious issues that OR leaders face, but its effectiveness as an efficiency—and therefore cost management—tool makes it worth pursuing. Implementing block scheduling requires time, finesse, and dedication. James X. Stobinski, PhD, RN, CNOR, says it’s easy for OR managers to underestimate the…

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In many surgery departments, schedule management is a daily struggle. Staff work hard to manage case requests, juggle resources, and respond to changes, but errors, inefficiencies, and general frustration persist. The results are frequent case delays and cancellations, low utilization, high costs, low staff morale, and poor surgeon satisfaction. The…

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