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Re-engineering the operating room using variability methodology to improve health care value.
C Daniel Smith1, Thomas Spackman, Karen Brommer
1Department of Surgery, Mayo Clinic in Florida, Jacksonville, FL 32224, USA. smith.c.daniel@mayo.edu
Journal of the American College of Surgeons
|March 26, 2013
Summary
Managing operating room patient flow variability significantly improves hospital performance. This strategy enhances efficiency, reduces costs, and boosts financial outcomes for surgical services.
Area of Science:
- Healthcare Operations Management
- Surgical Workflow Optimization
- Hospital Financial Performance
Background:
- Patient flow variability in operating rooms critically impacts hospital performance and finances.
- Distinguishing between natural (uncontrollable) and artificial (controllable) variation is key for effective resource management.
- Previous approaches lacked specific methodologies to address surgical services variability.
Purpose of the Study:
- To apply variability methodology to a hospital's surgical services.
- To improve operational performance through targeted variability management.
- To enhance financial outcomes by optimizing patient flow.
Main Methods:
- Classified operations as scheduled (artificial) or unscheduled (natural) over a 3-month period.
- Developed mathematical models to allocate resources for distinct patient flow streams.
- Implemented block time allocation, scheduled case time caps, and access guidelines to minimize artificial variation.
Main Results:
- Increased surgical volume (4%) and minutes (5%), with prime time use up by 5%.
- Reduced overtime staffing (27%) and day-to-day schedule variability (20%).
- Decreased same-day elective schedule changes (70%) and staff turnover (41%), improving net operating income (38%) and margin (28%).
Conclusions:
- Effective variability management demonstrably improves operating room operational and financial performance.
- This optimization strategy offers significant benefits for hospitals adapting to healthcare reform.
- Implementing structured variability control enhances overall hospital efficiency and profitability.
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