Surgeon behavior is a strong factor in your equation. All surgeons want to get the in-patietn elective cases early in the week so there are no cases over the weekend. One way to optimize the OR schedule is to have block time for in-patient surgery and ortho spread through the week and mix with outpatient cases that don’t need beds/ICU. You can incentives surgeons that have complex cases (need ICU or more than 2 days in the hospital) to operate on Mondays and Fridays (provided the weekend team are good enough to take care of such cases).
dedicating an anesthesia room to give appropriate anesthesia prior to bringing the patient to the OR is a key factor in OR efficiency. The incentive is volume of cases, not time. Therefore more case mean more money for everyone. The hospital C suite is your way to negotiate this deal. In hospitals that use a bundle payment system and the anesthesia is part of the bundle, it can be very effective and lucrative. The wheel-in, wheel-out is very tricky and requires a great deal of standardization, which is similar to the Toyota case. But in healthcare it is very unpredictable. Anesthesia should be part of the OR committee and discuss budget with the surgical teams as one unit.
This is an easy answer but a very tough execution! The benefits of technology is not the question (it’s obvious), but utilizing your resources is. What will you do with the same budget that is used for this technology? You are the only one that can answer that question!
The best way to have a meaningful use of a dashboard is to engage physicians to be part of creating it. Each department has it’s own metrics that they are interested as well as overall data that is based on the hospital. We have a cloud-based HIPPA compliant dashboard that can be extremely personalized and used on your phone. Going through the data in a weekly basis meeting forces everyone to use it.
We all know cultural change is hard but not adapting to the transformation is even harder. You can make everyone happy by using the new ideas and adding the old experience flavor to it. Make a team of old and new employees that can get along and come up with strategies to make the change as painless as possible. The faster the change, the sooner people adapt (or leave)! Go for the big fire.
This is a very challenging situation! I think it starts with changing the culture: education, education, education. You can utilize a rehab type facility and separate the patients that need acute care. A good strategy for maximization of your budget is the key, while you can start volunteer organizations.
This is a common issue as the conglomerate healthcare systems are taking over, which is not necessarily a bad thing! I would wait and see what happens to the AHCA but I think the best way to stay independent (for now) is to continue providing highest quality care but be “different”. It may be that you offer more services that others don’t provide. You’d be surprised how patient satisfaction can increase with small but important details such as in-hospital iPads to listen to music, movies, “spa” rehab, patient engagement, etc.
By “changeover times are too long” I assume you are referring to turn-over time between cases? I had the opportunity to be part of very efficient OR that the turn-over is less than 10 min. The efficiency of OR depends on anesthesia (i.e. blocks or spinal anesthesia are performed prior to OR), nursing (minimum 2 circulatory and 2 scrub techs in joint cases) and surgeons (standardizing procedures and maximizing proficiency). The personal have to be incentivized to be paid based on volume, not time. This way more cases will get done.