orm_november-2023 - 9

TECHNOLOGY
BY ELIZABETH STOCUM
Balancing the demand for OR time with resource utilization
O
Rs are a key revenue driver for
hospitals, with surgical services
accounting for nearly half of hospital
margins. Efficient use of OR time is
therefore critical to sustaining and growing
hospital revenue and profitability.
Perioperative leaders face an ongoing
challenge in optimizing OR utilization,
however, because of the common
mindset among stakeholders that block
time is the only means of accessing the
OR. Traditional block allocation practices
based on historical utilization rates often
fail to maximize primetime usage. Manual,
retrospective block management
processes cannot keep pace with dynamic
surgical volumes and schedules.
To optimize OR capacity and utilization,
hospitals are adopting a proactive,
data-driven approach supported by analytics.
Predictive and prescriptive analytics
enable fact-based decision making
for block allocation while minimizing the
role of organizational politics and maximizing
overall transparency.
Chris Hunt, associate vice president
of perioperative services at MultiCare
Health System, provided insights into
leveraging people, processes, and technology
to enhance block utilization and
allocation at a luncheon presentation
during this year's OR Manager Conference
in Nashville, Tennessee.
Traditional block allocation
challenges
Traditional block allocation practices
have several drawbacks that constrain
optimization of primetime OR use. Assigned
block time is traditionally granted
based on inheritance and anecdotal evidence
rather than data-driven factors.
For example, surgeons may receive
the same blocks as previous surgeons
in similar specialties instead of their
block time being aligned with current
surgical volumes. " Block allocation
methods rely on historical utilization
rates and 'inheritance,' " Hunt explained.
" Surgeons expect to receive
the same blocks as previous surgeons
www.ormanager.com
in that specialty. " Retrospective management
cannot keep pace with currently
shifting volumes. As such, block
practices based on past use often fail
to maximize primetime.
Block utilization metrics also fail to
provide a comprehensive view, being
based on flawed calculations and prone
to " gaming the system " practices due
to volatility in cases across surgeons
and service lines. Because of variation
in case lengths and complexities, utilization
rates are not comparable across
service lines.
One surgeon's low utilization rates
do not necessarily mean their block
assignments should be reduced, and
another surgeon does not necessarily
need more blocks when their utilization
rates are high. The arbitrary percent target
does not account for complications
like last-minute emergencies, or factors
like first case delays that are beyond
surgeons' control.
Policies and procedures outlining
block utilization guidelines that attempt
to establish rules on releasing
block time, either voluntary or involuntary,
often fail to allow for a strategic
approach to block allocation decisionmaking.
Auto-release policies to open
underutilized blocks are a band-aid
approach if they are not rigorously enforced.
Under these policies blocks are
often simply reassigned, despite time
remaining in the primetime gap.
A lack of clearly defined guidelines
for block allocation perpetuates politics,
inconsistency, and access issues.
Ineffective governance compounds the
problem. Block governance committees
that are not armed with reliable data
struggle to find effective solutions and
drive change. The lack of data results in
a rearview mirror approach to decisionmaking
versus a strategic, forward-looking
methodology. Consensus building
is also difficult without clear visibility
into facts and root causes of utilization
constraints, leading to stalemates that
maintain the status quo.
Benefits of leveraging data,
technology
Advanced analytics technology provides
the right knowledge to transform block
management from a retrospective, reactive
process to a forward-looking, optimization-focused
discipline shared among
unified stakeholders. " Our technology
partnership provides the data to make
decisions, " said Hunt.
For MultiCare Health, key capabilities
and benefits include:
* Real-time visibility into open OR time
that provides transparency and improves
access, allowing surgeons to
view opportunities and make optimal
scheduling decisions
* Credible, standardized metrics from
a single source of truth that enable
fact-driven decision making and consensus
building among block committee
members
* Prescriptive recommendations that
allow hospitals to apply proven best
practices for block utilization and
case scheduling
* Automated scheduling routine that improves
efficiency, so time once spent
on manual processes can be redirected
to value-added initiatives.
Using the knowledge gleaned from
advanced analytics, OR committees can
focus on driving improvements versus
debating opinions. Objective data transparency
promotes impartiality while enhancing
communication, and analytics
support better alignment of block allocations
with budgeted caseloads and
revenue goals. " Our technology partner
enables process change beyond just
software implementation, " said Hunt.
With analytics, committees can focus on
improvements versus debates.
MultiCare Health case study
MultiCare Health leveraged advanced
analytics to address capacity and management
challenges that constrained
primetime utilization. Limited capacity
due to construction delays along with
unplanned OR repairs and anesthesia
OR Manager | Nov/Dec 2023
9
http://www.ormanager.com
orm_november-2023

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