Efficiencies in the OR

Operating rooms can be called the “financial engines” of a hospital and are of vital organizational importance. From a risk perspective, postoperative wound infections, however, are the most common hospital-acquired infections (HAIs). This means that the Operation Room (OR) truly is a dynamic environment where the stakes are high. ‘How healthy is our OR?’ is, therefore, a very relevant question for every OR manager or executive. Where 10 years ago, human error still posed the greatest risk for a patient’s safety, today our attention should be focused more on proper integration of new technologies and OR protocols, as well as measuring and integrally discussing the results thereof (Sevdalis et al., 2012).

But how does one accurately and effortlessly measure the health of the perioperative environment? Which parameters are both indicative and available? How do we find the right balance between safety, efficiency and cost indicators? With shortages of staff and ever-changing IT landscapes, these questions will prove difficult to investigate – few have the time to dig into this, let alone actually measure and interpret the resulting parameters. Or implement good Quality Initiatives, to get compliance and performance levels up.

After many years of helping our customers improve their levels of patient safety and efficiency in ORs, we have summarized some of our experiences into a model of five main OR improvement categories. Benchmarking oneself with national best practices in each of these categories typically ensures very healthy discussions around these topics and will usually unveil all ongoing inefficiencies and safety risks in an OR. We help our customers get automated intelligence reports and become consistently best in class in each of the following areas:

1. Environmental parameters

Is it clear in what percentage of the daily cases, the air quality parameters all fall entirely within all acceptable limits? During how many operations per week, is either room temperature, humidity, or air pressure in the OR, actually not according to standards?

2. Patient safety score

Do OR teams know at the end of each case whether they have worked according to protocol? Is there an objective standard that can be measured and improved upon? Is there real-time feedback to teams around an objective team performance score and are these regularly reviewed with the teams?

3. Turnovers

The average daily turnover time between cases is often known. But what about the average turnover time per specialist? And the ongoing differences between certain days? Who are the outliers and what can we learn from them? What is the distribution of the underlying components of an OR turnover time? Do they differ substantially between comparable medical teams? What are the causes of these deviations..?

4. Utilization

With room or block utilization, it is important there is real-time insight into the use and occupation of OR’s and compare these to other teams or other locations. Are there fixed patterns of a particular operation or specialist? Does urgency or oncology often interfere with your planning, or is this due to other causes? What obstacles are there to schedule more cases in a day, or have higher scheduling accuracy? Can we factually pinpoint the limiting factors in order to be able to improve? With real-time visualization of relevant parameters and large blocks of unused OR time, many immediate chances for improvement become clear rather quickly.

5. Staff Productivity & Overtime

Do you have sufficient insight into how many and what type of cases staff members have worked on every month? How many (costly) cases are carried out in the Evening, Night or Weekend shifts? How much this varies from week to week and what the causes are? Are these truly emergency patients, or planned patients that got moved out of block times?

By measuring and making available all these relevant questions and conditions in real-time, the OR Performance Model of NewCompliance will make it entirely clear in which areas, and when, your OR department performance levels can improve significantly.

Would you like to walk through this model with one of our clinical consultants? Feel free to request an appointment. We can help to compare your values with regional benchmarks and discuss the scope for improvements we deem possible from our experiences. We are here to help you.

Sevdalis, N., Hull, L., Birnbach D.J. (2012). Improving patient safety in the operating theatre and perioperative care: obstacles, interventions, and priorities for accelerating progress.