Staying on time in the operating room is critical to every surgical practice. Whether an outpatient facility or a hospital department, keeping things running smoothly in the OR is imperative. In most cases, the focus is on patient turnover – how quickly can we clean up after one surgery and begin the next one?
Much more rarely does any surgical team take a peek at the surgical staff schedules to see how they might be impacting efficiency in the operating room. Yet, surgical staff scheduling plays a significant role in causing – and preventing – time waste, particularly in regards to provider preference, time allotted for each procedure and staff coordination.
1) Scheduling by Provider Preference
Think about how your surgical unit is scheduled. Are there any occasions when the preferences of a particular provider govern how the day is scheduled? Maybe you have a surgeon who likes to start at 8:00 am, not 7:00 am. Maybe they prefer a 2-hour block on Monday mornings. While scheduling according to surgeon preference may sometimes create a positive environment, it can also wreak havoc with the progression of the day’s surgeries.
To determine whether your scheduling method is at the root of any time waste in your operating room, review your staff schedules and historical data on case duration. See if a different approach might provide better results.
For instance, shorter blocks are generally less efficient than longer (8-hour or 12-hour) blocks, simply because they provide an opportunity to either run into another block or, if the surgical team finishes early, can leave a gap between blocks.
In some cases, there is one provider who always runs over; they are scheduled for two hours but take two and a half. When the data show that the problem is not insufficient time being allotted for the procedure but, rather, that a particular provider always needs more time, adjustments can be made.
If, for example, the provider running over is an ongoing situation in your practice, flexibility may be required. The most efficient approach may well be to simply schedule that provider’s blocks differently so that your surgery schedule can stay on track while accommodating the needs of that particular provider.
2) Insufficient Time
Nothing throws off a surgical schedule faster than an inadequate amount of time being scheduled for the procedure. Obviously, this is occasionally unavoidable but it can also indicate a need to review your schedules and see if they really make sense for your current situation.
Sometimes staff schedules are built based on “how we have always done it,” yet that is not an effective way to avoid wasted time. There are many reasons why a given approach to scheduling may no longer be timing out well. Perhaps the patient population has changed and there is now a greater chance of complication. Perhaps advances have changed how much time the procedure takes to perform.
Of course, it must also be considered that a practice’s preferred approach to building the schedule may never have been a good fit in the first place.
By regularly reviewing case duration times, you can feel certain you are allotting the right amount of time for each procedure. You will then be on top of any changes affecting duration and will be able to adjust accordingly, so that your surgeries are always efficiently scheduled.
3) Lack of Staff Coordination
It is not unusual for large hospitals to have separate schedules – often on separate systems – for each provider type. The coordination of surgeons, perioperative nurses and anesthesia is required to make the operating room run effectively so, when there is a lack of visibility into the schedules of each provider type, an unnecessary roadblock is thrown into the mix. By coordinating the schedules to provide this visibility or, ideally, by integrating them into a single schedule, the entire process from pre-op to post-op becomes more efficient.
While it is not necessary to have different provider types all on the same schedule, it is important that all members of the surgical team be able to see one another’s schedules. This not only promotes trust and teamwork, but helps reduce miscommunications.
Your Surgical Schedule is a Tool – Use It
Your surgical schedule should be designed to provide the utmost efficiency while also being flexible enough to adapt to the idiosyncrasies of your practice.
Think of your schedule as a tool that can be used to ensure a steady flow of patients through your operating room each day. When used in conjunction with historical data on procedures, it gives you structure to block out the day’s needs in an efficient fashion, can flex to accommodate changing needs and can help avoid miscommunications across your team.
For more information on surgical scheduling, see the video, OR Staffing Challenges.