Managing variability in perioperative services

Variability within perioperative services has come to be something physicians, perioperative nurses, and managers expect. Peaks and valleys in schedules; differences in physician preferences for surgical implants, instruments, and supplies; staffing competencies; and inpatient bed availability are just a few examples of day-to-day variability that affects perioperative services personnel. Rather than simply responding to variability, however, the goal should be to eliminate variability in patient flow as much as possible and effectively manage what cannot be eliminated. Combining the hard science of queuing theory and simulation modeling with the soft science of change management and operations improvement expertise is the key to success, and a collaborative team makes it possible.