Reducing variability in operating room utilization.

Abstract

321 Background: With a fixed number of operating rooms, as well as complexity of cases and volumes continuing to rise, it became important for MD Anderson to more effectively utilize the OR resources that are available. Methods: The initial intervention (4 years ago) was the development of a mechanism for effectively measuring and reporting both In-Block Utilization and Total OR Utilization. Through a systematic process of measuring and reporting OR utilization by day of week, all services began to pay closer attention to their data/utilization and began to engage in the process. The “OR Capacity” application was created, which enabled stakeholders to view overall booked capacity of the OR, as well as at the service level. This created complete transparency for all services to see how effectively they were using their block allocation by day of week, as well as across the month. Results: Reports produced monthly reflect each services overall In-Block Utilization, Total OR Utilization, as well as both of these metrics by case day of week. By viewing this data across all services, it provides transparency of utilization and where possible block swaps between services may occur. At the beginning of fiscal year 2009, the variability by case day of week of In-Block Utilization was 16% and 33% for Total OR Utilization. This wide variability was difficult for perioperative stakeholders to manage. Through a systematic approach of measuring, monitoring, and reporting, the most current data reflects the variability by case day of week of In-Block Utilization and Total OR Utilization has decreased to 3% and 9% respectively. Conclusions: By creating an application that provides transparency of OR capacity, as well as clear policies and procedures for block reallocation and how the measurement and reporting of block utilization would occur, we have demonstrated how a complex and multi-factorial issue of effective block utilization across the days of the week can be solved. This has required a multi-disciplinary team of individuals to work through and understand the issues, develop interventions, as well as the mechanisms to provide sustainable and ongoing monitoring and reporting of the utilization by case day of week. Without strong leadership, this effort would not have been possible.