First case on-time starts soar after rapid process improvement training
In 2011, fewer than half of all first cases at Dartmouth Hitchcock Medical Center in Lebanon, New Hampshire, were starting on time. That meant subsequent cases were also delayed, with overtime costs exceeding $500,000 a year. “People were unhappy with that for a lot of different reasons. It was a…
Surgical team familiarity reduces operative time, improves performance
Surgical team familiarity contributes to reductions in operative time, and performance improves as team experience accumulates, a new study finds. Previous studies of teamwork and its influence on surgical outcomes have been limited by the challenge of objectively quantifying teamwork. Survey-based methodologies are subject to responder bias, and the tools…
Collaboration and creative thinking hold down the number of OR holds
Putting a hold on the OR can lead to revenue losses no manager wants to see. At Lehigh Valley Health Network (LVHN) in Allentown, Pennsylvania, OR holds were averaging 1,100 minutes per month. Jodi Koch, BSN, RN, director of perioperative services, and Kathleen Duckworth, RN, CPAN, their colleagues got holds…
Using Lean strategies to improve operating room efficiency
Improvements in first case on-time starts and turnover time at Lancaster General Hospital in Lancaster, Pennsylvania, attest to the success of using Lean strategies. Within an 8-month period, first-case on-time starts (FCOTS) jumped from 35% to 72%, and the monthly average overall turnover time (TOT) for a 7-month period was…
Three-part strategy suggested to improve patient throughput
Efficient throughput—difficult to achieve, yet essential to long-term financial success—is a Holy Grail for OR nurse leaders, who spend much time and energy seeking it. Given all the demands of their role, how can leaders best use their time to gain the most benefit from throughput initiatives? One method is…
New staffing structure builds on success of specialty team model
Less than a year after adopting a “college structure” model akin to that of specialty teams, the UF & Shands Academic Health Center in Gainesville, Florida, is close to achieving a goal of 100% on-time starts. “We track first-case start times, and a report goes out every morning, so we’ll…
Fewer surgical cancellations occur after preoperative screening
Duke University Hospital has had a Pre-Operative Screening Unit (POSU) in place for the past 16 years to optimize patients prior to surgery, but until recently, there were no hard data on surgical cancellation rates. Now, a retrospective analysis has revealed that fewer cancellations occur when patients are seen in…
Efficiency soars in wake of strategic OR cultural changes
Changes in staff responsibilities and greater collaboration have contributed to dramatically improved first-case on-time starts at the University of Louisville Hospital, Louisville, Kentucky—from about 35% to 86% in a little over a year. Turnover time has been reduced, too, with slow but steady progress suggesting that revamping existing structures can…
The right strategies can help increase OR utilization
OR Business Performance is a series intended to help OR managers and directors improve the success of their business. How do you improve an OR’s financial performance? Last month’s column focused on two key strategies: using data to identify improvement opportunities and rallying support for organizational change. These strategies…
Benchmarking labor productivity: How is your OR being compared?
Productivity monitoring and management are near the top of the priority list for every perioperative nursing director. With 50% to 80% of a hospital’s costs in labor, staffing dollars are a big target for cost management. Some experts say hospitals and health systems will face budget cuts of 20% to…
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