Data-driven process to improve VA surgical flow.

Area of Science:

• Healthcare Management
• Operations Research
• Health Services Research

Background:

• Low operating room efficiency (ORE) impacts surgical program performance.
• The Veterans Health Administration (VHA) sought to improve ORE in underperforming surgery programs.
• A structured initiative was needed to address systemic inefficiencies.

Purpose of the Study:

• To implement and evaluate the Surgical Flow Improvement Initiative (SFII).
• To enhance operating room efficiency (ORE) across VHA Medical Centers (VAMCs).
• To assess the impact of SFII on key performance metrics and financial returns.

Main Methods:

• Developed an algorithm using first-time-start (FTS), cancellation rate (CR), lag time (LT), and OR utilization to assess ORE performance.
• Engaged 15 low-performing VAMCs in SFII, utilizing redesign methods for process improvement.
• Tracked metrics including FTS, CR, LT, OR utilization, and VAMC performance levels.

Main Results:

• Achieved significant improvements in FTS (45.6% to 68.7%), CR (16.1% to 9.5%), LT (63.1% to 36.3%), and OR utilization (43.4% to 57.7%).
• 86% of sites improved or sustained all four ORE metrics.
• Projected annual return on investment estimated at $27,949,966.

Conclusions:

• The SFII successfully enhanced operating room efficiency across a national healthcare network.
• The initiative demonstrated a cost-effective strategy using limited resources for significant improvements.
• This model offers a scalable approach for healthcare leaders to manage complex operational challenges.