When it comes to serious medicine, it’s the operating room that provides the linchpin for every health service system around the globe. However, operating rooms and the skilled teams that use them are not infinite. In fact, both the facilities and the surgeon’s capabilities are fairly limited and in high demand. So, any viable medical system has to plan and allocate the time available for the operating room utilization wisely. If not, the maximization of the resource’s positive impact gets wasted.
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An Old Problem Plaguing Multiple Health Delivery Programs
In the real world, bad scheduling, poor coordination of surgery resources, and last-minute changes end up causing operating rooms to go unused during prime hours. Whether it’s the unavailability of a qualified surgeon or missing equipment or a missing cleaning service, an offline operating room is a total loss every hour if it’s not being used correctly.
Part of the problem stems from how operating rooms are allocated in the first place. This traditional method of resource commitment, block scheduling, is commonly used in large and small programs, and it runs on a faulty assumption that medical professionals can be standardized, i.e. all surgeons are the same. That’s simply not the case. Some fields see high demands on a cyclical basis, others are seasonal, and still others spike erratically. So, no surprise, a scheduling system based on standardized use runs into conflicts right away with some surgeons having little need for their block time and others never having enough. Add in facility politics, administrative prioritization, and caseload shifts, and the operating room availability becomes a train wreck every week.
Even worse, the metrics of usage for evaluation and changes are based on the utilization of block time, which is faulty from the start. So, mistakes for new changes compound on old scheduling theory mistakes.
Forcing Change Without Old Paradigms
A zero-based budget approach is clearly what is needed every cycle. There is no guarantee that the surgeon who needs the operating room 27% of the time in one quarter will be the same the next. Instead, the window of availability and the reallocation has to be more frequent to match the actual demand and needs of the surgeon teams for a given facility.
Software and artificial intelligence come into play heavily when it comes to regular re-allocation. Given set parameters, scheduling through software has no biases or subjectivity. It evaluates available, given demand, new demand requests, and available resources and outputs the best algorithmic response every time. This evens out the resources match to need, reduces waste, and gets rid of politics. Further, the match of real demand to allocation can be tracked far better in a digital format than by simple block scheduling. This provides invaluable trend analysis that can help support future planning and resource budgeting going forward. Finally, where there is unplanned unused time and availability, it can be recycled and used versus entirely lost in terms of operating room availability. That’s a key revenue boost for any health program and will likely end up paying for the software approach over time.
The Biggest Challenge Tends to be People
Optimizing operating room capacity involves a huge change management challenge, and it’s going to have resistance both from traditional practices to internal organizational culture. However, the difficulty is worth the effort; the logistics prove themselves once the operating rooms start being used at full or close to full efficiency level. And the hospital will also typically see advantages in revenue impacts within the next two quarters as well. That will come from less downtime, far more utilization of resources and staff, increased scale of economies from a steady flow of supply to demand, and fewer disruptions in scheduling due to unavailable operating rooms.
A digital approach to operating room scheduling just makes common sense in today’s age. The tools are available, functional, and powerful. What needs to catch up is how human behavior approaches hospital logistics.
