Innovative approaches to address critical staffing challenges in operating rooms

Surgical case volume fluctuations due to inpatient capacity constraints have left perioperative departments with growing backlogs and critical staffing and resource shortages. How can hospitals better navigate this environment? During a March 16 webinar, leaders from Baptist Health in Jacksonville, Fla., and Oregon Health and Science University (OHSU) shared strategies for effectively managing OR backlogs, mitigating staffing and resource constraints, and optimizing capacity despite an unpredictable environment.

1 Visibility of the surgical schedule, backlog is essential

For many health systems, OR and clinic schedulers use email, fax and phone calls to book OR time. These methods lead to insufficient scheduling because schedulers don’t always have the most accurate, up-to-date information. By using an electronic scheduling management tool, schedulers can easily see the open and blocked OR times in real-time. They can also cancel surgeries through the tool and open the time to other surgeons immediately. The tool also enables a health system to better use their ORs and flex their staff because they have a better understanding of the needs across the enterprise.

2 Communication is key to improve OR efficiency

When a hospital or health system experienced surges during COVID, some OR rooms closed, opened at different times, or had specific criteria for booking surgical cases to conserve resources. This can be very difficult for OR and clinic schedulers to keep track of. An electronic tool, such as iQueue from LeanTaaS, that offers current information about specific guidelines in place for OR rooms is incredibly helpful. This streamlines the scheduling process, reducing stress for staff and errors. Baptist Health achieved a remarkable 17 percentage point (39.5%) increase in primetime utilization with iQueue for Operating Rooms despite multiple OR closures due to surges.

3 Use a tiered approach to offer stability during crises

It’s important for hospitals and health systems to have a roadmap in times of surge or when there is a pinch point in capacity. Creating tiers that indicate how many patients the ORs can admit is an effective strategy to accomplish this. The tiers are determined based on beds and staff that are available. A block schedule should also correspond to the tier. This provides schedulers with a reliable understanding of times they can book for surgery. Physician leaders should also be assigned to monitor the system and schedule urgent or unexpected cases when needed.

4 Be flexible and OR case volume when appropriate

At OHSU, OR teams and schedulers meet each week to discuss if there are openings in the OR schedule to book backlogged surgeries sometime in the upcoming week. To accomplish this, OHSU uses two tools from LeanTaaS: the Request Module and the Capacity Module. These tools allow OHSU to see patients waiting for surgery and keep only specific times open on the schedule. The tools provide OR schedulers with the confidence to schedule backlogged cases because the information they are viewing is up-todate and accurate.

5 Understand case length of surgeons to enhance predictability

ORs rely on many staff members including specialized nurses and anesthesiologists. When case lengths are not booked accurately, it’s frustrating for staff and patients because it can lead to delays in surgery start times. Providers should be tracking case lengths of surgeons and provide that information to the individual surgeons. This allows a surgeon to see if they are overbooking or underbooking time for cases. A discussion should then take place with the surgeon to adjust their schedule, allowing them to book their times for surgery or use a case predictor tool.

Watch the full webinar on-demand at www.modernhealthcare.com/LeanTaaSWebinar