Toward Operating Room Growth

INTRODUCTION

With the financial pressures most hospitals have recently experienced, you’ve likely considered different approaches to increase case volume and operational efficiency in your OR. In that consideration, you’ve probably encountered a variety of claims related to either cost savings or increased revenue from internal project teams, consultants, and software vendors. These success metrics can be misleading in different ways:

It's a recurring theme we hear at nearly every hospital. Surgeons distrust - or actively refute the accuracy of - reported utilization statistics. Do they have good reason for this doubt? Regardless, hospitals continue to rely heavily on utilization statistics when making decisions about allocating block time. Is this a sensible thing for hospitals to do? What are the implications?

You may have heard of the Prisoner's Dilemma before.  In case you haven't, here's a brief summary:  It describes a scenario where individual decision-makers have an incentive to make decisions that aren't in the best interest of the group.  The typical example involves two criminal partners recently arrested and interrogated separately.  The interrogator is trying to get each prisoner to testify against the other, with the prospect of going free for the testimony.  If both criminals remain silent, the police have no evidence and can't prosecute them - both go free.  If one testifies, they go free while the other goes to jail. If both agree to testify, they both go to jail.

When you're trying to make convenient OR time available to providers who need it, there are a number of problems you'll face, typically in the following categories:

• Political problems
• Behavioral problems
• Access-to-data problems
• Math problems (actually three math problems)
• Communication/coordination problems