The scheduling of surgical cases in the OR is a complex process that, if done inefficiently, can negatively affect patient satisfaction, staff satisfaction, costs, and the overall hospital.
This edition of Off the Shelf talks about creating an optimal OR schedule and why block utilization is typically the best way to go
Creating the Optimal Operating Room
Depending on who you ask, you will get varied answers when asking, what is the "optimal" strategy for OR scheduling? Administration would like to see all ORs utilized at all times at the lowest possible cost. Nurses typically like cases to adhere to the schedule with all cases completed by the end of the shift. Surgeons typically like the idea of having operating rooms available every day of the week so they can perform procedures as necessary. (Check out this brief case study to get an idea of the implications of a successful schedule)
OR leaders need to construct a schedule that leaves physicians satisfied and that responds to the requests of surgical beds. All healthcare facilities should establish an OR scheduling system that warrants continued patient flow to and from the OR. The tricky part is adhering to hospital budgets, time constraints, equipment, staff resources, and bed availability.
Important Factors of Efficient Schedule Development
- Balancing coverage with surgical demand
- Flexible access to OR rooms
- Maintenance of the right materials/equipment for each case
- Accurate estimates of case length times
- Knowledgeable/educated scheduling staff
- Adherence to policies and procedures for scheduling
- Establishment of OR committee to oversee process
Operating room scheduling is a multifaceted process where surgeon and staff resources, patient readiness, updated supplies and equipment, and room availability must be coordinated to obtain successful outcomes. Patient care as well as profits are affected by how fast surgeons can get patients through the OR process and under-utilizing surgeons can make both parties unhappy. Unavailable OR times and inaccurate and delayed start times lead to fewer surgeries performed in the facility which leads to lost revenue throughout the entire organization, not just in the operating room.
Optimal OR scheduling should consider the types of procedures to be performed, the allocation of time for each case, and the structuring of cases within the designated time. Delayed surgeons, last minute add-ons, gaps in the schedule, prolonged pre-operative LOS, low employee morale, number of first case demands, and lack of anesthesia coverage are all issues that contribute to an inefficient OR schedule.
Why Block Scheduling?
The goal of block scheduling is to maximize OR capacity by reducing the amount of vacant OR time. Arranging OR cases in block times for each surgeon has many benefits:
- Surgeons have designated days to perform procedures and are aware of these days in advance so they can make appointments without overlapping into their OR schedule
- Knowing the number of OR rooms allotted to surgeons allows you to plan and assign patients and the surgical team accordingly
- The hospital can easily manage and evenly distribute the workload throughout the week
A hospital with a good block scheduling system in place will have high surgeon satisfaction, high utilization, and a cost effective surgical department. Staff will be aware of start times and have equipment and supplies in place ready to go so as to not fall victim to tardiness.
Characteristics of a Good Block System
- Accessible to new surgeons
- Segment of block open for emergent and non-block surgeons
- Strong support from Administration
- Standards and restrictions of block policy upheld
- Periodic review of block utilization by surgeon/practice
Block scheduling is a systematic method to resolve various scheduling difficulties in the operating room. While it reduces the idle waiting time in the OR, it also decreases wait time for patients, allowing for improvement in the quality of patient care and substantial efficiency advancements in hospital operations.
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