OR Manager - February 2020 - 4

Mastering predictive modeling to improve patient care
OR Business Management Conference
T
he Best in OR Business Award
is presented annually at the OR
Business Management Conference
to recognize an outstanding leader
who has saved on costs, increased OR
utilization, improved patient safety, or
otherwise streamlined the surgical services
department.
The 2020 award will be presented
to Vikram Tiwari, PhD, associate professor
of anesthesiology, biomedical informatics,
and management at Vanderbilt
University School of Medicine and
Vanderbilt University, as well as director,
surgical analytics, at Vanderbilt University
Hospital. Since joining Vanderbilt
in 2012, he has demonstrated skills in
leadership and innovation that meet the
criteria for the award.
Vikram
Tiwari, PhD
" My interest in healthcare
developed during
my doctoral studies and
led to my thesis on coordination
and capacity
management in hospitals, "
Tiwari says. With a
doctorate in operations
management and decisions
sciences from Indiana University
Bloomington, as well as engineering and
MBA degrees, Tiwari has helped OR leaders
at Vanderbilt better understand how
to use data to inform decision making
and increase efficiency.
Power of predictive analytics
" Thanks in large part to his expertise
in predictive analytics and passion for
serving patients, we can much more
efficiently tailor our operating room
staffing levels to our case volume, "
notes C. Wright Pinson, MD, deputy
chief executive officer (CEO) at Vanderbilt
University Medical Center (VUMC)
and CEO of Vanderbilt Health System.
" This has made a significant difference
in our organization and serves as
a best practice for hospitals throughout
the country. "
Cindy Kildgore, MSHA, RN, CNOR,
perioperative services director at VUMC,
echoes that praise. She told OR Man4
OR
Manager | February 2020
ager that Tiwari built and maintains
data sets within Tableau, such as first
case on-time starts, turnover times (by
hour of the day, as well as the components
of turnover time), and financial
cost per case/per surgeon. " He has
significantly impacted our ability to increase
our volume with sufficient knowledge
of future needs, " she says.
" At VUMC, we thrive on innovation,
and leaders encourage and support new
ideas, " Tiwari says. Having that culture
helped ease the way for adoption of advanced
analytical methods.
" The predictive modeling we have
done to predict our daily surgical volume
has helped many different departments
in our hospital, " he says.
The model, constructed in 2013, has
recently been updated to reflect
surgical volume that
the
is now higher
than when the model was first used.
" We are also now able to predict case
volume very accurately up to 30 days
out, " he adds. " We have separate
models for each day of the week, as
well as for each of the 30 days into
the future. "
Tiwari's predictive analytics, Kildgore
says, have been used to help shift
outpatient volume off site. Tiwari used
simulation modeling to determine how
many ORs could be accommodated
in this new ambulatory surgery center
without compromising the holding
room (HR) and postanesthesia care unit
(PACU). " That work proved that we can
have one additional OR in lieu of fewer
HR/PACU beds, " he says.
Tiwari notes that implementing any
process change requires demonstrating
that the new process will create
less, not more, manual work, and that it
won't inadvertently overload some other
part of the system. " Seeing through the
lens of systems thinking when crafting
changes helps get better buy-in from
the affected stakeholders, " he explains.
" We also rely on validated data metrics
and measurements for effective
monitoring of improvements in performance. "
In
addition to his data analytics
work, Tiwari is a researcher who has
published extensively, and he teaches
courses in healthcare operations management
and healthcare analytics to
MBA students. " The inspiration for my
research and teaching comes from real
issues of capacity management planning
and process efficiencies faced by
our hospital that I work on intricately, "
he notes.
He sees analytics as a way to
achieve better care for patients. " The
most rewarding accomplishments are
those where some aspect of my analysis
helps these people, " he says.
" We have just started to scratch
the surface of the analytics toolkit, "
Tiwari adds. " Most of what we still
do will be described as 'descriptive
analytics,' that is, reporting data retrospectively.
I want to develop tools for
predicting future states to help decision
makers proactively improve resource
usage. I also want to leverage
organizations like OR Manager to help
spread the word on the potential of
using scientific techniques to better
manage an organization's capacities
and capabilities. "
He believes that continuously learning
and staying curious are important
for success. His advice for aspiring
leaders? " Those who show a positive
attitude, are team players, take the initiative,
and are ready to challenge themselves
tend to stand out, " he says.
These characteristics are reflected
in Tiwari's many accomplishments and
have earned him the admiration and
respect of colleagues and leaders at
Vanderbilt. True to form, Tiwari not only
is a past presenter at both the annual
OR Manager Conference and the OR
Business Management Conference, he
also is presenting " The Power and Perils
of Data Analytics " on January 29-
the same day he will receive the Best in
OR Business Award.
To learn more, visit www.ormanager.
com/managementconference. ✥
-Elizabeth Wood
www.ormanager.com
http://www.ormanager http://www.ormanager.com
OR Manager - February 2020

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