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Using block scheduling to improve OR efciency
Leslie Knudson
Managing Editor
With as much as 60 to 70 percent of hospital revenues tied to the OR,1 the OR represents the greatest source of
protability for hospitals and the most costly, resource-intensive component of hospital operations.2 Surgical volume variation can make it difficult to control patient ow and can contribute to underutilized ORsthe average OR runs at approximately 68 percent capacity.3 Eective scheduling that maximizes the use of personnel, equipment, and rooms is essential to maintaining OR efficiency. Block scheduling, which assignsa block of OR time to each physician or groupof physicians across a designated time period,has proven to be an eective approach for coordinating surgical resources and improving overall utilization of the OR.
Overcoming efciency roadblocks
Many barriers can hinder OR efficiency, including scheduling errors, surgery cancellations, and limited supply and equipment availability.
A majority of the contributing factors can be attributed to scheduling-related issues. Laterst case starts can derail an entire days OR schedule and can be caused by a variety of factors, including health care personnel tardiness, delayed room setup, equipment or supplies not being ready or available, and patient delays. Health care personnel can make eorts to reduce late starts and help ensure the timely arrival of patients to the preoperative area. For example, providing proper preoperative instructions to patients and having patients complete medical records and other documentation available prior to case start
time can help ensure that patients will be ready in time for their scheduled surgery.4
Standardizing preoperative patient evaluation, eliminating rst-case scheduling barriers, and improving admission processes can also help ensure on-time starts.2 Standardizing processes for preadmission testing and having patients prepared in time for the day of surgery is extremely important, said Debbie Homan, EMBA, BA, RN, specialist master at Deloitte Consulting, LLP. Homan also recommends nurses aligning themselves with anesthesia personnel and surgeons to identify standardized processes and eliminate unnecessary tests.
Room turnover is a major contributing factor to OR efficiency. It is key to understand the denition and measurement of turnover time
A BLOCK SCHEDULING APPROACH that uses a blend of block, open, and urgent or emergent access time helps maximize OR use.
BLOCK...