Five ways to build an efficient OR team
November 23, 2020
By Alyssa Rapp
The operating room is the financial engine of the modern hospital, with the average general surgeon bringing in more than $2.7 million in revenues per year for their hospital. These revenues keep facilities in the black and help to keep our entire healthcare system afloat. Far too often, and particularly during stressful and chaotic times like these, inefficiencies can creep in that make it hard to keep ORs firing on all cylinders.
In turn, inefficiencies that cause temporary cost spikes can inspire cost-cutting measures and even furloughs or layoffs that make it harder to run an OR team, creating a spiral of inefficiency and penny-pinching that can quickly leave hospitals in a serious financial jam.
Fortunately, by focusing on a few key areas it's possible to build a more effective OR team. Here are five key steps you can take to streamline your OR, and help ensure a continuing flow of much-needed revenue for hospitals during this difficult time:
Stay on schedule. The cost of time spent in the OR has been estimated at between $22 and $133 per minute according to The Journal of Clinical Anesthesia, so maximizing efficiency starts and ends with ensuring that operations begin on time and don't run longer than they should. You'll need an effective system for blocking out OR time — and a clear rationale for how you assign time-blocks to cases. Just as importantly, you'll need to make sure everyone turns up on time, and has the records and documents they need to hit the ground running. Even a 15-minute pre-operative delay will quickly add up over the course of a busy day's work.
Accelerate turnovers. Just like a restaurant owner turning tables, hospital administrators need robust systems in place to minimize downtime between OR procedures. But be careful: pressuring teams to turn ORs around too quickly can lead to corner-cutting and problems with quality of care. One option: bring in dedicated teams to disinfect and clean up ORs between procedures, so your in-house teams can stay focused on delivering quality care and managing the "traffic cop" side of ensuring that physicians and patients are in the right place at the right time.
Cross train your teams. Brain surgeons don't perform hip replacements during their downtime, but some OR team-members such as nurses or technicians can be cross-trained to play multiple roles. Still, cross-training can bring headaches when dealing with unionized workforces, or when trying to identify which skills a particular employee has mastered. Supplement your in-house expertise by keeping a trusted third-party provider on speed-dial. The right partner can deliver specialized support on an as-needed basis, allowing you to keep costs low without impacting quality of care.
Be smart about equipment. Missing or malfunctioning equipment accounts for more than 55% of surgical delays, so eliminating bottlenecks and ensuring teams have the tools they need should be a top priority. Make certain your scheduling system accounts for the specific tools that will be needed for any given procedure, and also allows time for routine maintenance and sanitation processes. Consider pooling resources with other local providers or using leased or on-demand equipment suppliers to get the equipment you need without spending heavily on new capital investments.
Focus on teamwork. The OR is a complex machine with multiple moving parts, from equipment and personnel to institutional issues such as scheduling and patient management. Remember, any changes you make in one area of OR management will have a ripple effect on other stakeholders — and can ultimately have a huge impact on overall patient satisfaction. Be sure to keep communicating effectively, and reminding everyone that they're all ultimately on the same team.
Seize the moment. With hospitals working to clear surgical backlogs and restore lost revenues from postponed procedures, there's never been a more important time to reevaluate the efficiency of your OR teams. Even before COVID-19, the average hospital was working with a margin of just 3.5%, so there's simply no room for inefficiency as hospitals fight their way through this challenging period.
Managing an OR during a pandemic was never going to be easy. But like with any crisis, the chaotic times we're currently living through can bring real opportunities for institutions to make overdue improvements to the way they operate. Everyone understands that changes to the status quo are inevitable during these challenging times — and that creates a window during which healthcare leaders can rationalize changing OR systems with less internal resistance than they might otherwise encounter.
Smart administrators will use the current moment to drive changes through their hospitals or hospital systems that will improve the OR experience for everyone, reducing costs and delivering lasting improvements to patient care. If we manage our ORs effectively during this moment, we can set ourselves on a steadier path forward as we emerge from the coronavirus crisis.
About the author: Alyssa Rapp is the CEO of Surgical Solutions, a health care services company owned by Sterling Partners. She is also a lecturer in management at Stanford Graduate School of Business, adjunct professor at the University of Chicago Booth School of Business and the managing partner at AJR Ventures.