Surgery

Reengineering the OR and Redesigning Surgical Inpatient Flow for Improved Quality, Safety and Throughput


Mayo Clinic, Jacksonville, Florida (Phase I)

        

  • Surgical case volume increased by 4%
  • Surgical minutes and OR utilization increased 5% each
  • Average OR overtime staffing decreased 27%
  • 84% compliance with waiting time limits for emergent and urgent care
  • No reported incidences of not being able to access OR in a timely manner
  • Annual staff turnover cost reduced by $1.07 million
  • OR annual net revenue increased by $5 million

Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio (Phases I-III)

        

  • Weekday OR waiting time for emergent/urgent surgical cases reduced by 28% (despite an increase in case volume of 24%) (Phase I)
  • Weekend OR waiting time decreased by 34% despite an increase in volume of 37%) (Phase I)
  • OR overtime reduced by 57% (Phase I)
  • Surgical throughput increased by 5% (an equivalent of an additional OR) (Phase I)
  • Multi-year 7% increase in annual surgical throughput without adding new ORs (Phase II & III)
  • $115 million increase in annual revenue/cost savings (Phase II & III)
  • Over $100 million in avoided capital cost (Phase II & III)

The Ottawa Hospital, Ottawa, Ontario (Phase I)

The Johns Hopkins Hospital, Baltimore, Maryland (Phase I)

  • Waiting time for emergent/urgent surgical cases decreased by 39%
  • Throughput increased by 5 cases per day in the main ORs and by 4 cases per day in their outpatient facility
  • Overtime decreased by 6.6%
  • Relative increase in surgical volume resulting in annual $4 million increase in incremental margin

Boston Medical Center, Boston, MA (Phase I and Phase II in one unit)

  • Surgical throughput increased by 10%
  • Emergency Department ambulance diversions reduced by 20%
  • 2.8 hour wait in one of the state’s busiest EDs compared to 4-5+ hours for most academic hospitals in Boston
  • Annual number of postponed or cancelled elective surgeries reduced by 99.5%
  • Reduction in nursing stress levels: 30 minute reduction (6%) in nurse hours per patient day in the step-down unit, resulting in $130,000 annualized reduction in nursing costs

Palmetto Richland Memorial Hospital, Columbia, SC (Phase I)

  • 3% increase in surgical volume
  • 38% decrease in weekday waiting time for non-elective cases
  • Opportunity to further increase surgery volume with $8m projected annual margin increase with $2 million achieved in the first year

HackensackUMC Mountainside, Montclair, NJ (Phase I)

        

  • Improved elective OR block utilization resulting in increased capacity for 1,000 cases annually without additional resources
  • More than 95% of emergent/urgent patients can access the OR in a timely manner, thereby decreasing their ALOS by almost 40%

Monmouth Medical Center, Long Branch, NJ (Phase II)

        

  • Increased patient satisfaction score from the 88th  to the 99th percentile of comparable hospitals
  • Decreased variability in nurse workload (number of admissions, transfers, and discharges) by over 40%
  • Significantly decreased PACU boarding
  • Increased throughput resulting in an annual margin improvement of $411K

Great Ormond Street Hospital for Children, London, England (Phase II)

  • An average increase of 2.2 cardiothoracic theatre procedures per week (representing a minimum increase in annual revenue of £1.72 million), meaning that they can treat more children urgently requiring specialist surgery
  • A decrease of 2.5 stress-related nursing shifts lost per week, representing an annual saving of more than £30,000 in agency costs
  • A weekly decrease of 2.3% in theatre procedure cancellations
  • An increase in theatre utilization from 55-60% to 80%

Elliot Hospital, Manchester, New Hampshire (The largest Maternity Ward in New Hampshire)(Phase I)

  • Eliminated morning chaos
  • Reduced the demand for additional staffed beds by 6 positions (50%)
  • Improved quality of care