Transformation of an OR

Reducing the cost and improving the efficiency of a surgery suite is one of the more complex operational challenges in all of business. Olson Institute helped to improve the flow of an operation suite at a large regional hospital. An analytical model was constructed to demonstrate the how to target improvements in the system. Then the Olson Institute co-implemented a practical solution based on the model.

The Challenge

Scheduling for an operating room is a very difficult challenge. Most operation suites in hospitals contain several different surgery specialties, many different doctors and nurses and conduct many different types of surgeries. On the day of surgeries, several actions must occur in the proper fashion in order for the operation room to conduct all the surgeries scheduled for the day. Patients must be prepped and ready for surgery, sign their consent to conduct the surgery and, most importantly, show up for the surgery. If any of the elements that the hospital and staff must conduct are not done or are done improperly or if any of the steps required of the patient are done poorly, the surgery needs to be cancelled and rescheduled for another date. In this particular institution this scheduling variance occurred about 20 percent of the time.

In addition to the challenges of scheduling, other patients in the hospital may require or need emergency surgery, often called urgent surgery. These patients, because of the nature of their surgery, take priority over some of the less life-threatening procedures. All of these issues make scheduling a nightmare for most hospitals, and many procedures are postponed due to one of these events. For the patient, this causes problems since they need to postpone their surgery. In some instances, their issues may become more critical or they may end up switching facilities, which in the end costs the institution a lot of revenue and damages their reputation.

Conference Room

The Solution

This solution was a combination of analytical analysis and operations improvement implementations. An analytical model using monte carlo simulation was created to model the OR environment and a series of lean and practical solutions were created to address the scheduling issues.

Clean Clinic Room

Monte Carlo simulation is a technique to simulate the variables in the operating environment to determine where there is opportunity for improvement. What our team learned from this situation was that the changes in the schedule that were created from the urgent surgeries, patient violation of surgery rules and incorrect procedures being followed were leading to approximately seventy-five percent schedule attainment.

This led to a series of solutions that helped to remedy the solution. The solutions involved both analytical solutions to better isolate the variance and practical solutions to help deal with the issues that were created internally. Some specifics include better pre-operating room procedures, better management of specific cases that are scheduled through the system, better overall allocation of facilities.

These improvement efforts have yielded substantial gains in the following areas

  • Improved schedule attainment
  • Improvement in morale
  • Translates to financial solvency