Are My Operating Rooms Properly Allocated?

Many, if not all, operating room committees look at block allocation and utilization, but other than a few changes, most block schedules are static and legacy protected.?

It got me thinking… how do I really know if my block time is allocated properly? And what does properly really mean?

It always seemed odd to me that we make a ‘plan’ for clinical operations- our budget, and a ‘plan’ for surgical cases- our block schedule, but the two never were discussed together. We also are good at measuring budget vs. actual cases/minutes and block utilization percentages, but something still felt off.

Why is it that some services are always scrambling for additional time while others seem to coast along? For example, I had a urology group that would beg, borrow and steal any time they could to get into the OR. Looking into it further, I was surprised to see their case volume over time wasn’t growing exponentially, and actually was kind of flat.?So why the scramble for time?

I wondered what it would look like if we compared budgeted minutes/cases to allocated block minutes to actual minutes (with adjustment for after-hours and out-of-block cases).?The premise being, are we setting our services up for success or failure with budgeted volumes that are adjusted annually while the block schedule is only adjusted if someone drops below a subjective percentage threshold.?

Looking back at the urology group, they were budgeted say around 80,000 minutes, were allocated 60,000 minutes, and were actually using 90,000 minutes while orthopedics was budgeted around 90,000 minutes, allocated for 120,000 minutes and using 75,000 minutes. ?It was no wonder why urology was always picking up any time available!

To help address this perpetual scramble, we are going to try a different approach for us in that we have reached out to our physicians and office and service line administrators to all get together and make “the mother of all boards” and list all of our surgeons by service and schedules on a wall to visualize both the clinic's and the OR's schedules together.?We hope that by getting together and visualizing this work we can start to link budget, block time and actual time to maximize efficiency in all of our areas.

I’m excited for this work and hope to send an update in a few months with the results. If you have an interest, and want to discuss more, please reach out and I’m happy to connect.

#OREffciency #BlockUtilization #Surgery