orm_november-2023 - 31

TECHNOLOGY
BY BRITA BELLI
How health systems are using tech tools to make ORs more
efficient
M
ost hospitals agree that they
can better harness the data
they are collecting from registration
through discharge in order to
streamline patient turnovers, reduce
wait times, and improve patient and
staff satisfaction, but there is still uncertainty
about how best to turn massive
quantities of data into better patient
outcomes.
Now, hospital systems are increasingly
turning to " healthtech " startups
to implement new systems that can be
seamlessly integrated into their existing
operations. And many are finding that
rather than requiring added training, or
creating new burdens for staff, these
tech innovations are pulling from existing
data-and video streams-and providing
information to staff via screens
and cellphones in real-time so they can
better focus on patient care.
If solutions are not intuitive,
says Jane Kuhn,
MSN, RN, CNOR(e),
NEA-BC, consulting editor
at OR Manager, they
are not going to work.
" These are very hard
systems to change, "
Kuhn says. " A hospital
is made up of many people
with many different
Jane Kuhn,
MSN, RN,
CNOR(e),
NEA-BC
belief systems, with varied backgrounds
and educations. "
And, adds Kuhn, a hospital's primary
priority is its patients, whose immediate
needs can fluctuate for any number of
reasons. So, while addressing delayed
start times is important, she says, it
can never be the highest priority in an
OR. " We can aim to improve on-time
start from 35% to 85%, but we can't
expect 100%, " she says. " There are too
many variables. The patient is late. The
patient needed extra reassurance. "
Thomas Feo, CEO and cofounder of
Healthcare Control Systems (HCS), says
the unpredictability of patient care and
constant disruptions-from unexpected
www.ormanager.com
OR staff constantly have to plan against
last minute scheduling exceptions.
case cancellations to
sudden influxes of patients-is
what makes a
whole-system approach
necessary when implementing
new tech-driven
efficiency measures.
HCS provides an auThomas
Feo
tomated coordination system called ORControl
that manages the movement of
patients, physicians, staff, and equipment
in real time, allowing hospitals
to improve start times, increase procedures,
and reduce overtime. Tablets in
each OR, cell phones of key stakeholders,
touchscreens throughout the facility,
and staff workstations simultaneously
display information from a wide
variety of existing data sources allowing
healthcare workers to make adjustments
on the fly.
The system draws data not just from
the electronic health record (EHR), but
all procedural areas and out-of-departments,
says Feo, a computer engineer
who first designed facility-wide coordination
systems for the manufacturing
industry in the 1980s, and later for the
transportation Industry. The ORControl
System coordinates catheter/epidural,
endocrinology, gastroenterology, anesthesia,
surgery, and sterile processing-
over 20 departments and groups in all.
" If it's a real control system, it has to
coordinate a very wide scope, " he says.
The data feeds are immediately clear
and actionable. For example, staff are
alerted when a patient is wheeled in,
how long the case is expected to last,
when the room is ready to be cleaned,
and when the patient is expected in the
PACU. The alerts (over 50 in all) can be
manually turned on and off as needed.
Whether it is a hospital, factory, or
transportation center, say Feo, there
will always be last-minute disruptions
that must be immediately addressed by
frontline personnel. " Our largest hospital
has 83 ORs. Imagine the logistics of getting
even 70 cases off at exactly 7am.
On top of that, no matter how good your
scheduling or planning system, or your
process improvement consultants, or
your AI forecasts, staff still has to deal
with constant last minute exceptions.
That is why an automated minute-by-minute
coordination system is so loved by
frontline staff. If a procedure gets canceled,
the system can seamlessly put
another case and team in that room. "
ORControl is deployed in healthcare
systems across the US and Europe, including
the top four systems in the U.S.
Benefits documented by these medical
centers range from 95% on-time first
starts to 50% reduction in room turn
times, including a 35% increase in case
volumes during prime time.
Why efficiency matters
" Patient flow " describes the way patients
move through a healthcare facility. It has
a lot of components, including care, resources,
and systems needed to properly
process and treat the patients. Improving
patient flow not only improves the hospital's
efficiency and allows healthcare
systems to handle more cases and improve
revenue, but it also directly impacts
patient health and well-being.
A report in NEJM Catalyst found that
poor patient flow is associated with increased
readmittance and even higher
mortality rates. In addition, poor surgical
planning in particular, such as scheduling
the bulk of elective surgical proceOR
Manager | Nov/Dec 2023 31
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