Operating Room

How does AI and ML streamline Block Allocation and Utilization Rates in the OR?

By Chris Hunt, AVP Perioperative Services, MultiCare Health System

Many, if not all, operating room (OR) committees look at block allocation and utilization, but other than a few changes, most block schedules are static and legacy protected. 

It got me thinking… how do I really know if my block time is allocated properly? And what does properly really mean?

It always seemed odd that we make a ‘plan’ for clinical operations – our budget, and a ‘plan’ for surgical cases – our block schedule, but the two never were discussed together. We are also good at measuring budget vs. actual cases/minutes and block utilization percentages, but something still felt off.

Why is it that some services are always scrambling for additional time while others seem to coast along? For example, I had a urology group that would beg, borrow and steal any time they could to get into the OR. Looking into it further, I was surprised to see their case volume wasn’t growing exponentially over time, and it was actually kind of flat. So why the scramble for time?

I wondered what it would look like if we compared budgeted minutes/cases to allocated block minutes to actual minutes (with adjustment for after-hours and out-of-block cases). The premise is that we are setting our services up for success or failure with budgeted volumes that are adjusted annually. In contrast, the block schedule is only adjusted if someone drops below a subjective percentage threshold. 

Looking back at the urology group, they were budgeted around 80,000 minutes, allocated for 60,000 minutes, and used 90,000 minutes. In comparison, orthopedics was budgeted for around 90,000 minutes, allocated for 120,000 minutes and used 75,000 minutes. It was no wonder why urology was always picking up any time available!

To help address this perpetual scramble, we tried a different approach in that we reached out to our physicians and office and service line administrators to all get together and make “the mother of all boards” and list all of our surgeons by service and schedules on a wall to visualize both the clinic’s and the OR’s schedules together. We hoped that by getting together and visualizing this work, we could start linking the budget, block time and actual time to maximize efficiency in all of our areas.

We also incorporated the budget to block actual data into our Block Utilization Committee to provide an additional data point to help evaluate new requests. In addition to this data, we utilize a best-in-class software and service technology partner to utilize machine learning (ML) and artificial intelligence (AI) for additional insights.

The results have been pretty phenomenal.

We were able to:

  • Increase primetime utilization by 24%
  • Increase the number of cases per staffed OR by over 50%
  • Improved Staffed OR utilization by 4%

Overall, this work has been a great example of bringing the right people together, empowering them to make a difference, and utilizing 21st century technology to accelerate their success.

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