Co written by Michael Besedick, Engagement Manager
In February 2009, The Health Information Technology for Economic and Clinical Health (HITECH) Act[1] spurred major investments into hospital Electronic Health Record (EHR) systems across the nation. Eleven years later, many hospitals still struggle to harness the power of these systems to drive operational and financial improvements, particularly within surgical services. Cleaning, manipulating, and sifting through vast data sets is challenging for many organizations, and convincing surgeons to trust the information they’re presented adds another layer of complexity. As hospitals face trends toward value-based reimbursement and anemic margins[2], they will depend on the ability to unlock hidden value using advanced analytics to manage risk and improve their bottom line.
One recent Surgical Directions’ client, a 597-bed, 22 OR academic medical center on the east coast, was facing pressure to improve the efficiency of its surgical services. Surgeons were unhappy with their ability to access the operating room due to a fully blocked schedule, despite monthly reports showing routinely low block utilization. Surgeons felt disgruntled, wondering how it was so difficult to schedule a case or accommodate their afternoon add-ons when many of the rooms seemed underutilized.
In order to tackle this issue, the joint hospital and Surgical Directions team established a Surgical Services Executive Committee (SSEC), a collaborative governing body comprised of surgeons, anesthesiologists, nursing, and administrative leadership that relied on insights from an advanced analytics platform built by Surgical Directions. The SSEC had a central role in driving the hospital’s perioperative transformation and was responsible for establishing the data definitions used for all analytics and reporting.
The advanced analytic platform included interactive dashboards that provided granular insights about how blocks were being used and managed throughout the organization. An OR usage visualization showed that over a 6-month period, over 500 allocated blocks never had any cases scheduled into them, driving down overall utilization and limiting access for other surgeons eagerly trying to book cases. This translated into roughly 4,000 hours of sub-optimal OR usage and severely limited access to valuable OR time, reinforcing surgeon perceptions. Only 17 allocated blocks were proactively released and credited over the same period.
The team then simulated the effect of how an efficient, proactive block release process would impact overall block utilization for groups that consistently failed to release their unused time. In one salient example, we estimated that if unused days had been proactively released, it would improve the group’s utilization from 40% to 89%. From these results, the team concluded that proactively releasing blocks would be an effective way to enhance access to OR resources and improve OR utilizations. Surgeons, staff, and administration would all benefit, as this behavior promotes responsible scheduling practices and allows for sufficient lead time when booking cases. It would also have a load-balancing effect, permitting more efficient accommodation of urgent and emergent cases.
After seeing a >8% YoY improvement in overall block utilization, it became clear to the organization that effective release practices were a driving force in improving access. Surgical Directions’ analytics platform helped the organization triangulate how each block was used, who was accountable for using the block, and where opportunities existed to better align capacity with demand. Most important, however, was a structured governance body powered by accurate data that held all participants accountable for efficient use of OR resources and time. The combination of targeted analytics insights and empowered governance allowed the hospital to unlock hidden value in its data to radically transform its culture of perioperative efficiency.
[1] HITECH Act (2009) Information retrieved from: https://www.hhs.gov/hipaa/for-professionals/special-topics/hitech-act-enforcement-interim-final-rule/index.html
[2] Modern Healthcare (2019), “Operating margins stabilize, but not-for-profit hospitals still vulnerable.” Retrieved from: https://www.modernhealthcare.com/providers/operating-margins-stabilize-not-profit-hospitals-still-vulnerable
