Contributor: How 2 Health Systems Improved Perioperative Productivity and Efficiency

As hospitals look to expand their surgical services in the near future, Mudit Garg gives 2 examples of how these changes can be made effectively.

Health care systems are under extraordinary financial pressure from inflation, decreased revenues, staffing shortages, and the lingering effects of the COVID-19 pandemic. To recover, leaders must improve the productivity and efficiency of their perioperative services, but manual processes are preventing many from accomplishing this critical goal.

That was among the key takeaways of a survey of hospital executives conducted by The Health Management Academy. The survey was conducted in August 2022 and was completed by 21 executives whose titles include chief medical officer, chief operating officer, vice president (VP) of perioperative services, VP of operations, VP of surgical specialties, surgical chair, clinical enterprise lead, and business operations director for surgical services. The responding executives represent 19 health systems with an average total operating revenue of $6.3 billion.

The survey found that increasing surgical services revenue is a top priority for 76% of executives, and 52% of health systems are planning to increase investments across the surgical service line in the next 2 years. At the same time, the majority (71%) of health system executives reported that 11% to 30% of their health system’s operating room (OR) time is not optimally used.

At 95%, nearly all responding executives are looking to automate OR scheduling more and rely less on manual processes. Overall, top strategies to increase surgical revenue growth included improving OR scheduling and access (81%), growing case volumes (71%), and increasing surgical referrals to reduce patient leakage (57%).

Given the numerous operational challenges facing health systems, such as labor shortages and escalating supply costs, it has become critical for hospital leaders to optimize OR efficiency and increase OR access, because surgical services account for a significant portion of hospital operating margins.

Following are the stories of 2 health systems that, while not part of the survey, have invested in automation software and seen subsequent improvements in perioperative access, utilization, and growth.

Increasing surgical access and utilization
A 16-location health care system based in Kansas City, Missouri, sought to boost operational efficiency to accommodate rising patient demand and optimize staff efficiency with fewer workers available. Because care teams still relied on highly manual tools and processes, leadership knew that the health system needed new automation capabilities to improve operational performance.

To accommodate pent-up demand for OR time, the system is using predictive analytics to improve utilization and increase perioperative access and growth. Machine learning predicts unused blocks of time weeks in advance and proactively offers available OR time to surgeons and schedulers. As a result, the system is able to serve more patients, with fewer open OR rooms and fewer available staff, allowing the health system to exceed budgeted surgical case volumes. Over a 1-year period since automating surgical operations, the hospital system has added 920 new OR cases and seen an 8-day average increase in released OR lead time.

Simplifying surgical access and growing volume
Another example can be found at an 8-location, Arkansas-based health system that is a primary referral site and regional destination for complex surgical care. As the health system sought to increase surgical volume, it faced significant pressure to accommodate growing surgical demand and improve efficiency.

To address these challenges, the system automated its care operations by leveraging modern innovations in artificial intelligence (AI), machine learning, and behavioral science. The automation solution enables surgeons and schedulers to view all available slots that meet their needs in a matter of seconds without logging into the electronic health record system.

To further increase access, AI identifies and automatically offers ideal slots to surgeons and schedulers. Additionally, machine learning predicts unused blocks weeks in advance and then applies principles of behavioral science to incentivize release of the time, increasing available OR time.

Finally, the solution provides perioperative leaders with instant access to performance metrics, such as primetime utilization, block utilization, and scheduling accuracy. This enables more impactful feedback discussions and more productive surgical governance discussions. In the first year since the hospital system implemented this automation, OR utilization increased by 80% and surgical operating margins grew by $1.8 million.

The operating pressures that have made 2022 an extremely challenging year for hospitals are unlikely to recede any time soon. Expenses are high and volumes are low compared with prepandemic levels, making it likely that many hospitals will end the year in the red, according to a recent report from Kaufman Hall. To make up for these deficits, many hospitals will look to their surgical departments for increased revenue. By automating surgical operations, health systems can create an efficient and profitable perioperative business that helps them achieve high-priority strategic growth objectives.

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