Pooled Open Blocks Shorten Wait Times for Nonelective Surgical Cases

Area of Science:

• Healthcare Management
• Surgical Operations
• Data-Driven Strategies

Background:

• Massachusetts General Hospital faced significant perioperative throughput challenges between 2009-2010.
• Over 30% of nonelective surgical patients experienced delays, impacting care access and bed availability.

Purpose of the Study:

• To assess the impact of a data-driven scheduling strategy on improving access to care for nonelective surgical patients.
• To evaluate the effectiveness of an
• open block
• strategy in enhancing surgical patient flow.

Main Methods:

• Designed and implemented a centralized
• open block
• strategy for nonelective surgical patients during prime operating room hours.
• Utilized discrete event simulation to predict the impact of adding operating rooms on patient delays.

Main Results:

• Average preoperative wait time for nonelective surgical patients decreased by 25.5% (P < 0.001) after implementation.
• Surgical patient volume increased by 9% while wait times decreased.
• Bed-days occupied by nonurgent patients pre-surgery declined by 13.3% with a 4.5% volume increase.

Conclusions:

• The
• open block
• strategy significantly improved nonelective patient flow at MGH when operating room availability was a key issue.
• Development of rigorous metrics was essential for performance evaluation.
• Strong managerial leadership was critical for successful organizational change and implementation.