Hospital OR & Non-HC Service Lines, Part II

Posted on June 6, 2014

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[See previous post, Hospital OR & Non-HC Service Lines, Part I]

Other than utilization of resources (and that’s a huge one), the main difference between the multi-billion-dollar a year beverage manufacturer and a sub-4% margin hospital? The rigor with which a service line is managed each day.  This intensity extends to the study and analysis executed by our manufacturing client before altering anything.

The beverage client will make no changes to its service lines until it confirms the planned changes will in fact work.  How? Haskell analyzes the process and modeling scenarios through simulation.

No capital investment is made until each proposed design is tested against existing conditions (physical space, resource capacity which includes employees) and numerous ‘what-if’ disaster scenarios. In the end, revenue must be ensured. Simulation is the only tool that reliably provides this for our client. Only when client metrics are hit in each of the scenarios, will Haskell get the green light to proceed with the design. Millions of dollars are at stake each month.

In February, I attended a process improvement conference where Operating Suite efficiency was a topic of discussion. In the case study presented, work flow, or the connected series of steps in a care-giving process, and work flow controls were a key focus. Real-time information was important for adjustments to be made, and for information sharing. The study recognized the OR was a self-contained department (micro-view), and also part of a system that was connected to related departments like the NICU, blood bank, and pathology lab (macro-view).

Two of the sound bites to come out of that session:

“People love getting information to do their jobs better…You need to use data to manage your OR.”

“Pie charts and bar graphs will not cut it in my organization. You are expected to chart variation. You are expected to collect, manage and react to the data.”

Most of this information came from RFID tags, which were attached to everything: equipment, rooms, clipboards. When asked about push-back from the use of RFID tagging, the response was: Disney is using it for room keys, park passes, meal plans. It is safe, manageable and used successfully by other industries.  The alleged Big Brother argument against RFID is weak compared to the power of information it provides for process improvement; it is a tool to be used for major benefit, as evidenced by an article yesterday in Health IT Outcomes about Florida Hospital’s adoption of the technology.

In the case study, this information fed an OR work flow control system that uses visual controls, tracks critical equipment, sends proactive alerts of conflict, notifies families and clinicians, tracks metrics, and sends notifications to surgeons and anesthesiologists to improve throughput. The results are improved patient safety, operational efficiency (first case starts, turn around time, pre-op check in, surgery check in, room cleaning), patient satisfaction, staff satisfaction, and delay reduction.

Clinical process analytics and simulation modeling help arrange the physical space in your OR, and your resources—equipment, people, supplies—in an optimal way. Then, advanced tools like an OR work flow control system can be put in place.

These tools are not new, and are employed by other industries successfully to bring in millions of dollars. If for-profit companies entrust their service lines to simulation and process optimization, why not healthcare? For 40% of a hospital’s revenue, an OR is a good place to start.

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