The High Performance OR

Elevating Efficiency Through Strategic OR Management

21 best practices to help hospitals optimize improvement efforts, align stakeholder interests and address other key issues in OR strategic management.

Executive Summary

Innovations in clinical technology and procedural techniques have dramatically changed the surgical landscape. Technological developments have enabled completely new surgery types, such as complex minimally invasive approaches. Technological innovations have also accelerated the shift of procedural cases from inpatient to outpatient sites—re-writing many of the most fundamental assumptions in health care delivery.

Administrators charged with running an efficient surgical workshop are familiar with the day-to-day consequences of macro-level health care changes. With the lapsing of the specialty-hospital moratorium, hospitals can expect even more intense competition from physician-owned surgery programs. To win—or even defend—surgical program market share in a sector crowded with hospital and non-hospital competitors requires hospitals to fight to distinguish their workshop’s value proposition.

In a Clinical Advisory Board survey, 80 percent of hospital surgical administrators indicated that high-tech surgeries—despite shorter recovery times—take up more time on the OR schedule. Improving surgery efficiency will prove an even greater help to the 77 percent of hospitals that, because they never have to turn cases away, presumably would like to attract more business from existing surgeons and bring new surgeons into the workshop. These hospitals must use surgery efficiency—which,is more than just throughput improvement—as a way to build the “workshop of choice” for surgeons. Beginning with the basics, this means eliminating the three major sources of surgeon dissatisfaction with hospital ORs: chaotic, unpredictable operations, lack of convenient schedule access, and the curbs on surgeon productivity.

In short, surgeon time is the major bottleneck to growing the majority of surgery programs. Whether by raising the productivity of already-loyal proceduralists or by winning new cases from skeptical surgeons now taking cases to more congenial sites, creating a predictable, convenient and productive workshop will go a long way toward advancing most hospitals’ strategic goals with regard to surgery.

Over the past year, the Clinical Advisory Board research team has engaged in a detailed study on hospital surgery efficiency improvement. This publication details the top practices that, when implemented in combination with one another, will allow hospital administrators to achieve the ultimate goal—a high-performance OR. These tactics and case examples provide a blueprint for leveraging strategic operating room management for maximum productivity and business development gains. Together, they will help hospitals optimize improvement efforts, align stakeholder interests, and finally, redefine the surgical enterprise.

Pressure on OR margins from both increasing costs and decreasing price growth has forced many surgical units to focus on cost reductions in order to maintain profitability. This publication provides strategies for leveraging operating room management to achieve greater productivity and revenues. After reading this study, members will be able to:

  • Boost surgeon schedule productivity
  • Accommodate new business using existing resources
  • Redefine staff culture for greater efficiency and long-term growth
  • Ultimately, re-envision the surgical enterprise

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