---
title: "Block Utilization Issues: Why They Matter and What to Do About Them"
description: Surgeons doubt - or outright deny the accuracy of reported OR utilization statistics. Does this make sense? What are the implications? Let’s talk about utilization and why it matters in your hospital.
---

[Block Smarter. Boost Revenue.](https://blog.copienthealth.com/blog)

# [Block Utilization Issues: Why They Matter and What to Do About Them](https://blog.copienthealth.com/blog/block-utilization-issues-why-they-matter-and-what-to-do-about-them)

 Written by [Michael Burke](https://blog.copienthealth.com/blog/author/michael-burke) | Oct 13, 2022 3:16:43 PM

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?

#### Variation in Utilization

Let's start with the accuracy of utilization statistics. Dexter et al. demonstrated in [*Anesthesia 2003*](https://www.researchgate.net/publication/10785782_Operating_Room_Utilization_Alone_Is_Not_an_Accurate_Metric_for_the_Allocation_of_Operating_Room_Block_Time_to_Individual_Surgeons_with_Low_Caseloads) that utilization for blocks allocated to individual surgeons varies widely over time: 

> "If during a 3-month period a surgeon's measured adjusted utilization is 65%, there is a 95% chance that the surgeon's average adjusted utilization is as low as 38% or as high as 83%."

 

Service-level blocks offer some variability protection, but often at their core, are really just a collection of either implicit or explicit sub-blocks with the same sort of variability mentioned above.

#### Playing Tetris

We also know from playing the game of [Tetris](https://en.wikipedia.org/wiki/Tetris) that it is much easier to fill open block time with smaller chunks of time rather than larger chunks. As such, surgeons with longer-than-average case durations will, all else being equal, have lower utilization simply due to this Tetris-related challenge. This can lead to sub-optimal block allocation decisions.  How and why?

The "why" is that block allocation decisions are often not driven by a hospital's true strategic imperatives.  The "how" comes from a variety of sources, including:

- - acting on inaccurate utilization data
    - prioritizing utilization above something that might be more important; possibly contribution margin per OR hour?
    - failing to consider resource constraints (ICU or step-down unit capacities, robot rooms, C-arms, etc.)

Optimizing block allocation is a bigger topic than we'll cover in this blog post.    
The takeaways for now are:

- - Identify problems with your [utilization reporting](https://www.copienthealth.com/measure/index).
    - Fix them if you can.  If not, don't rely on the data or report it to surgeons.
    - Be thoughtful of the role utilization plays in your block allocation decisions.

#### For more information, check out a [past post](https://blog.copienthealth.com/blog/the-math-of-block-time-optimization) that outlines variables to consider in the optimization of OR utilization.

 

[View full post](https://blog.copienthealth.com/blog/block-utilization-issues-why-they-matter-and-what-to-do-about-them)

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