February 21–24, 2016
Renaissance Phoenix Glendale | Glendale, AZ
Pre-Conference Workshop: February 21, Conference: February 22-24
Supply acquisition typically consumes more than 50% of the surgical services department budget. To write a master business plan for perioperative supply management, OR leaders must know the top 10 categories to include in the plan and the critical factors involved in prioritizing them: early wins, key staff influencers, physician support, resources to effect change, and education allotment. Workshop participants will gain a deeper understanding of preference card management, inventory management, technology and systems, case cart management, room turnover, staff productivity and talent utilization, standardization, surgeon and staff satisfaction, safety, and sustainability.
Learning objectives
• Discuss the top 10 categories of a supply management business plan for surgical services.
• Review the specific details for each of the top 10 categories and how to analyze them.
• Apply the five critical factors for prioritizing your business plan.
Changes in healthcare delivery are coming from all fronts, and providers must understand the changes and adopt transformational processes and systems to ensure compliance with new regulations, meet patient safety standards, and maintain a high level of service. In this dynamic keynote presentation, Siddel will walk the audience through the latest Medicare requirements, the disruption of new technology, patient empowerment, and how to manage the impact of potentially lower reimbursement. Drawing on his extensive experience in regulatory compliance and with revenue cycle issues, he will explore the most important changes in healthcare reform and delivery and offer a vision of the lean future.
The presentation will contain previous methods for capturing data and utilization rules and changes made that reflect improvements in efficiency and cost savings.
Learning objectives
• Understand how to develop and standardize OR block guidelines in an academic system.
• Standardize reporting of block utilization and criteria for removal.
• Develop two-room guidelines and utilization.
Stress is a pervasive fact in the daily work of healthcare professionals, affecting not only the care givers themselves but also the quality of care they provide. There are ways to enhance mindfulness at the bedside and beyond, and leaders can adopt strategies to enhance organizational and individual mindfulness practice. Let’s ditch the drama with its inevitable burnout and start minding the bedside!
Recent trends in American healthcare may soon affect the nature of nursing professional development activities. The possible future direction of nursing professional development will be presented with an emphasis on the potential impact of changes in healthcare financing. Information such as the latest Institute of Medicine reports on this subject and a handout on Needleman’s concept of Invisible Architecture and its impact on nursing will be provided.
Learning objectives
• Relate changing perceptions on the individual responsibility for professional development.
• Discuss the increasing attention on competency assessment from accreditation agencies and certification organizations.
• Describe recently introduced theoretical frameworks related to nursing professional development.
This presentation will demonstrate how to map surgery services process metrics to corporate strategy, including strategic financial, quality, and service outcomes. The multidisciplinary leadership team and behavioral change approach integrates Lean Six Sigma initiatives with strategic goals to meet Affordable Care Act requirements.
Learning objectives
• Develop a clearer understanding of the revenue impact of process improvement projects on critical financial, service, and clinical measures.
• Redefine operational metrics and dashboards to link staff actions to strategic outcomes.
• Identify daily metrics that help physicians and staff stay focused on organization priorities.
The perioperative surgical home (PSH) is a multidepartmental initiative aimed at transforming surgical care by improving quality, lowering costs, and increasing patient and provider satisfaction. The presenters will explain the conceptual framework for this model and how to implement it, with emphasis on staff scheduling challenges and recommended approaches.
Learning objectives
• Define the full scope and major operational elements of a prototypical comprehensive PSH model.
• Define how the PSH model will improve quality and safety of perioperative care and reduce hospital readmissions.
• Identify staff scheduling challenges and best practices to address them.
Vanderbilt University Medical Center developed a “virtual nurse” role to complement the work of nurse practitioners in preoperative assessments of elective surgery patients. Registered nurses phone patients to obtain medical/surgical history and documentation. If RNs find additional testing is needed, a lead NP reviews the case, or an in-person appointment can be made or tests can be ordered. This system allows RNs and NPs to maximize their skill sets in providing patient care, ensure proper preparation for surgery, and optimize patient flow. The facility has also piloted video conferencing with an offsite clinic.
Learning objectives
• Describe the impact of a virtual nursing role on the perioperative experience, including FTE/budget.
• Describe the role of virtual nursing vs clinic nurse practitioners.
• Describe the value added to patients as a result of virtual nurse engagement.
Wearable technology such as Google Glass provides hands-free, voice-activated Internet access, allowing surgeons to “float” medical images in their field of vision without diverting attention from the operative field. Advantages include immediate access to data and images, diagnosis and treatment for patients en route to hospitals, pinpoint accuracy for tumor location, and live-feed streams for educational purposes. But there are also risks such as perceptual blindness (tunnel vision), distraction, and potential violation of patient privacy. The exciting evolution of this technology, as well as its implications for perioperative nursing, will be discussed.
Learning objectives
• Identify ways in which personal wearable technology is a source of distraction, such as reading email during surgery.
• Review aspects of patient security and privacy violation, such as online streaming of confidential information.
• Discuss concerns such as images being automatically uploaded to the cloud.
Little information exists on how perioperative clinical systems can drive protocols and alerts to ensure compliance with surgical infection prevention policies. Instead of reviewing data postoperatively for compliance, learn how to use your information systems to evaluate your surgical site infection (SSI) prevention program, involve your clinical informatics team, and assess the entire perioperative process, including clinical workflow, alerts, and reminders to achieve greater compliance with SSI reduction efforts.
Learning objectives
• Review current surgical site infection prevention and compliance requirements
• Discuss how perioperative information systems design can provide proactive measures to support SSI prevention efforts
• Discuss post surveillance and how new technologies can provide streamlined data and care information
Studies have shown that nurse burnout and fatigue can lead to worse patient outcomes, such as higher rates of catheter-associated urinary tract infection and surgical site infection. Yet when it comes to enhancing patient safety, organizations tend to focus more on process improvements than on how the highly stressful OR environment affects caregivers. Understanding the consequences of “compassion fatigue” and finding ways to combat is something all healthcare leaders should be trying to achieve. In this presentation, you’ll learn how to identify the signs of compassion fatigue, how to create a work environment to minimize its effects, and how to build a case for programs that address this problem. The presenter will provide tools and techniques for reconnecting caregivers with their passion and purpose.
This case study on same-day total hip replacements performed at Lincoln Surgical Hospital will include factors such as the importance of team selection, patient selection, the development of clinical protocols, and discharge planning for these procedures. The presenters will share lessons learned—both successes and pitfalls.
Learning objectives
• Assess feasibility of outpatient total joints in your organization.
• Describe the development of protocols.
• Discuss the benefits and challenges in outpatient total joint replacement.
• Evaluate how outpatient total joints can impact the bottom line.
Providing timely communication to a patient’s family and friends is a crucial part of the overall surgical experience. Companions often hesitate to leave the surgical waiting room, fearing they might miss an important update from the surgeon or staff. At Memorial Medical Center, waiting room staff can log into the application for a real-time dashboard view of all active surgery patients and their associated companions, eliminating the need for manual schedule updates and paper notes. The application uses the companion’s cellular device to deliver two-way messaging between staff and patient companions throughout the surgery. Surveys have shown an increase in patient satisfaction, including an overall decrease in anxiety level and greater satisfaction with communications.
Learning objectives
• Understand patient companion expectations in the surgical waiting room.
• Engage nurses and physicians in the surgery communication process.
• Review Mutare’s Vital Link Surgical Status Update application.
The ophthalmologic surgical services at Scarborough Hospital’s Birchmount Campus had significant variations in practice that increased turnover time, delayed access to care, and adversely impacted patient and staff satisfaction. By standardizing documentation, instrumentation, and supplies, as well as improving efficiencies and safety practices, patient throughput increased by 113% (from 3,700 cases in 48 weeks to 5,900 cases in 36 weeks). Leadership capacity and frontline staff engagement also increased.
Learning objectives
• Discuss the impact of variation in clinical practice on funding and managing variation in practice.
• Identify the importance of process mapping and Value Stream Mapping in driving improvement work.
• Determine how to empower frontline staff engagement in implementation of best practices to drive improvement and manage operational challenges.
OR leaders are counted on for their vision and their ability to effectively get others to share in the vision. Yet, OR staff and other hospital staff often perceive the OR as a silo. The presenters will provide some techniques for breaking barriers that keep OR leaders from achieving their goals, and tips for building collaboration and trust throughout the organization. Dispel the myths that the OR is a foreign country within a homeland, and create the relationships with staff in other departments that contribute to making the OR as productive and efficient as it can be.
Learning objectives
• Recognize need for collaboration and relationships outside of your own paradigm.
• Discuss ways to streamline communication and build relationships with OR and other hospital staff.
• Review the value of relationship building as well as “the speed of trust.”
Efforts to identify the causes of error in healthcare have highlighted the link between teamwork and safety and sparked interest in improving communication. Although the literature has reported on 360 degree peer evaluation processes conducted with physician groups, little has been published on use of the process with RNs and other clinicians. Our quality improvement initiative involving a 360 degree peer evaluation with RNs and surgical technologists at a community hospital achieved sustainable results. We will discuss implementation challenges and successes as well as tips for conducting a 360 degree peer review in other operating rooms and clinical environments.
Learning objectives
• Describe the correlation between workplace behavior and patient safety.
• Identify at least three recommended activities that should before implementing a 360 degree process.
• Discuss at least one way in which 360 degree peer evaluation processes have correlated with improved clinical outcomes.
Shrinking reimbursement and tightening quality requirements are squeezing surgery department margins. Yet a few leading hospital ORs are poised to thrive, thanks to a handful of innovative strategies—collaborative leadership, information transparency, delivery model innovation, and super-charged efficiency. Learn how leading health systems overhauled their ORs to improve performance and drive growth. Participants will receive tools to evaluate current OR performance and learn strategies to erase performance gaps, as well as how to engage physicians to drive change. Strategies to reduce readmissions, surgical site infections, and complications will be also be presented.
Learning objectives
• Identify strategies for success under value-based payment
• Describe the role of surgeon-specific information in driving surgical outcomes and costs
• Discuss the role of collaborative governance models to optimize perioperative performance
A comprehensive, agreed-upon perioperative performance dashboard can be used to manage OR efficiency, drive operations decisions, and focus on quality and financial improvements. By identifying the types of data to be monitored and using clearly defined benchmarks, a perioperative dashboard can be built that presents a monthly snapshot of department performance. These benchmarks and goals provide a framework for the entire surgical team to use as the basis for pursuing opportunities and making educated operational decisions.
Learning objectives
• Define the use of dashboards/scorecards to drive performance improvement measures.
• Discuss feasible strategies to promote the use of an OR performance dashboard and surgeon scorecard.
• Understand which metrics and benchmarks are important to measure for efficient and effective surgical services departments.
Concepts based on Lean, operations research, and change management were used to achieve efficiencies and flexibility in staffing within the postanesthesia care unit (PACU) and same-day surgery (SDS) unit. Historical staffing models did not reflect changes in the patient flow patterns over time. The mismatch between demand and capacity was reduced by analyzing the temporal patterns in patient flow (demand and capacity alignment), applying best practices in patient care, enhancing staffing skill sets, and using change management concepts. Optimizing staffing led to savings of $125,000 in the PACU, $125,000 in SDS, and $250,000 in endoscopy, along with improvements in staff competency and scheduling.
Learning objectives
• Assess the impact of health care funding reform in the Canadian healthcare system.
• Discuss the use of data and trending to determine staffing levels to match activity.
• Learn how to apply change management to implement sustainable improvements.
• Describe a robust approach to flex staffing models to meet variation in demand.
Value analysis is a way to achieve optimal value in managing the supply inventory. However, it’s hard to know which products to focus on when developing a value analysis project. And even when a product category is known, physician leaders are faced with coordinating a contracting strategy and aligning medical staff with that strategy. When political capital is on the line, physician leaders need to know how to spend it wisely. This presentation will show physician leaders how to identify worthwhile value analysis projects, manage contracts, and integrate physician input into the project. The key to aligning physicians is to create a compelling “what’s in it for me?” case for the medical staff. This presentation will highlight what physicians really want in exchange for their collaboration in the value analysis program and how to provide it to them.
Learning objectives
• Identify the physician leadership role in the supply chain.
• Describe the clinical assessment process for team development.
• Discuss how supply chain management is moving into population health management.
The goal of this session is to demystify issues surrounding a very complex surgical device. Regulatory and statutory guidance documents are becoming more comprehensive, protocols impacting flexible endoscope use and its environment are challenging to meet and/or manage, and misunderstood responsibilities for care, traceability, and/or maintenance are multifaceted, fragmented, and confusing. How confident are you in the endoscopy services you manage?
Learning objectives
• Identify the critical steps for endoscope reprocessing.
• Discuss regulatory and statutory requirements for maintaining endoscopic equipment.
• Describe evidence-based guidelines used for training on endoscope care.
An increasing spine surgical volume and decreasing contribution margin prompted staff at Overlook Medical Center, Atlantic Health System to use Six Sigma methodology to analyze their spine program. The team consisted of core members from the OR, corporate strategic sourcing, finance, reimbursement, medical records, neuroscience/orthopedic service line administration, key physicians, and others. The goals were to improve OR throughput, increase charge capture and reimbursement, standardize products, and improve physician and staff satisfaction. A spine technology committee was formed to vet new products prior to use, streamlined processes were implemented, and $3 million in savings was achieved.
Learning objectives
• Define the Six Sigma methodology applicable to supply chain management and standardization of processes.
• Describe the processes used to achieve a successful project implementation utilizing data analysis.
• Describe methods to increase active participation and collaboration of physicians and administration.
A major challenge for OR business managers is achieving and maintaining optimal OR utilization targets. Commonly quoted standards suggest an optimal OR utilization rate of between 70% and 80%, with 75% being appropriate for most ORs. Anything below 75% is often seen as an opportunity for improvement, and OR utilization below 65% generally causes concern about costs, profitability, and organizational effectiveness.
Learning objectives
• Identify the components of OR utilization: definitions, calculations, realistic and optimum targets.
• Discuss how to accurately analyze and assess OR utilization at your facility.
• Describe ways to improve low OR utilization.
The management of operating room inventory is a continual challenge for all healthcare institutions. In this session we will explore some ideas related to management of consignment products, the use of data in inventory forecasting and eliminating waste and expired products, and exploring the effective use of supply chain automation in the OR setting. The presenters have extensive experience in OR inventory activities and bring a unique perspective to this operational issue.
Learning objectives
• Discuss methodologies for implementing, managing, and reconciling consignment inventories across different product categories and utilizing contracts within the process.
• Determine how to utilize data to improve OR inventory performance and to mitigate negative impacts to the organization’s bottom line.
• Evaluate and consider automation solutions in the OR inventory space.
Big-board digital communication displays help to educate and celebrate the OR community, as well as influence our OR culture. Leveraging visual communication technologies and using strategic in-house marketing can help achieve staff buy-in, decrease rollout anxiety, and raise community awareness. We will discuss content sourcing and design, medium limitations, and short-term/long-term impact.
Learning objectives
• Identify the messaging options available for mass communication in the perioperative environment.
• Determine if digital communication displays are effective and how they work.
• Describe how visual communication technology can improve your OR culture.
Between now and 2025, the transition from volume-based care to value-based care will undergo three waves: patient-centered care, consumer engagement, and science of prevention. Cross-industry competition (healthcare vs retail vs technology vs others) will erase traditional boundaries and generate exciting new value propositions for patients, payers, and physicians. Healthcare leaders who focus and transform their care delivery with the patient in mind will be the winners. To succeed, they will need to understand data analytics and industry market dynamics, and they will need strategies for making the transition to value-based care.
Learning objectives
• Develop strategies to improve quality, outcomes, and patient satisfaction.
• Prepare for changes in contracts and delivery models toward shared/full risk population health management with better payer contracts and bonus opportunities.
• Discuss strategies for data analytics for offline as well as at the point of care.
Healthcare management will face revolutionary change during the next few years: provider consolidations, insurance mergers, increased focus on the overall cost of care, and the push to improve outcomes. All these will test our abilities to change and manage in a different environment. As leaders in our field, we hold the power to help guide this change. The need for sound data analytics, personnel management, and coordinated plans will force us to shift gears and rely on different tools. The presentation will cover the impact of these changes, and the leadership challenges they’ll bring, and ways to engage the key stakeholders within the OR and the C-Suite.
Changes are needed in the credentialing processes for vendors who provide their expertise on new surgical devices during procedures. Lack of product standardization has led to unnecessary costs, and device manufacturer representatives who try to comply with facilities’ credentialing requirements are spending additional resources to redocument what has already been done. Meanwhile, noncompliant representatives continue to find ways to work outside the system. The supplier community wants to help drive compliance and thus meet patient safety and confidentiality goals, but success depends on collaboration with healthcare providers.
Learning objectives
• Discuss the work that has been done thus far to refine credentialing.
• Learn about options to address problems with credentialing.
• Describe how better credentialing processes can provide value to suppliers and providers alike.
Anesthesia influences many care areas and patient experiences throughout the hospital, not just the OR, and anesthesia underperformance can significantly affect a hospital’s bottom line. This underperformance can cause unpredictable and sometimes untraceable financial losses. In this presentation, we will examine the causes and effects of anesthesia underperformance and the key performance indicators that should be used to transparently track, measure, report, and improve performance. We will explain how these indicators can be used to improve anesthesia operational, financial, and qualitative performance.
Learning objectives
• Discuss the various components of quality anesthesia management and a clear vision of an effective provider.
• Understand evaluation criteria with regard to clinical outcomes, operational efficiency, and financial return.
• Formulate an action plan to achieve the desired clinical, operational, and financial improvements based on evaluations.
Moving to a paperless patient tracking system has reduced cancellations and increased patient throughput at LifeBridge Health, Sinai Hospital, Baltimore, MD. More importantly, it has eliminated inaccurate data transfer and duplication of efforts, thereby increasing efficiency and enhancing the patient experience. The customized system, OPTIMI$ERTM, is HIPAA compliant and can interface with any electronic health record or HL7 IT system. The presenters will discuss their transition to a whole new workflow that is based on best practices observed in hospitals across the US.
Learning objectives
• Discuss reduction of same-day case cancellations and delays.
• Identify ways to increase patient throughput.
• Discuss improving Magnet Certification and JCAHO readiness.
Organizations implementing Lean systems, methods, and tools must transition from just using the tools to creating a culture of process improvement. David Mann (The Missing Link: Lean Leadership) asserts that a successful Lean transformation should focus 20% of the time on implementing tools and the other 80% on changing leaders’ practices and behaviors. Our goal was to develop service line leaders who consistently practice desired behaviors and excel at teaching and coaching for improvement and problem solvers able to work through rapid improvement cycles. We will describe how we created a culture of process improvement in the perioperative service line, with interactive demonstrations and data on quality, cost, and efficiency.
Learning objectives
• Discuss the components that support daily improvement.
• Demonstrate ways to improve operational efficiency, engage employees, and develop a culture of problem solving.
• Describe how to recognize leaders as teachers who can demonstrate desired behaviors.
Moving away from paper, fax, and telephone scheduling requests from the physician offices to electronic booking requests improves physician loyalty, block utilization, workflows, and patient safety. An electronic system displays block utilization in the physician offices in real time as they request a booking for every patient or for each block submission. The financial impact is dramatic.
Learning objectives
• Identify ways to track utilization and block submission by service and physician.
• Analyze how secure electronic messaging between physicians’ offices, scheduling office, and the preoperative area helps to reduce costs.
Identifying your top drivers of success will enable you to implement and take new service lines to the next level. Sky Ridge Medical Center in Littleton, CO, has a reputation as a destination facility that goes “beyond expectations.” What has built this reputation? A culture that thrives on competition and growth while emphasizing the core values of safety, courtesy and compassion, efficacy, and efficiency. Discover the steps leading to successful new service lines that demonstrate improved patient safety and management as well as surgeon satisfaction.
Learning objectives
• Identify an opportunity to develop a new or existing service line into a destination service.
• Outline key steps to develop a comprehensive service line focusing on quality outcomes as well as physician and patient satisfaction.
• Discuss integration models and processes that will engage surgeons and improve their satisfaction.
• Explore programs and technologies that can improve patient throughput and reduce same-day cancellations.
• Identify measures to track and improve patient outcomes.
Missing instruments and supplies is often the biggest source of frustration and expense in an OR. The sterile processing department rapidly becomes the center of attention when problems arise, and often SPDs seek a quick fix, which can lead to repeating the same problems over and over. Such was the case at Riverside Regional Medical Center before the organization decided to invest in changing the processes and culture of the department.
Learning objectives
• Accomplish process redesign without construction.
• Communicate why the staff schedule needs to be reworked.
• Demonstrate why working with SPD staff on change management principles will help over the long term.
Today’s OR leaders are surrounded by those with an agenda for them: surgeons, anesthesia providers, senior leaders, and staff. It’s difficult to manage the everyday operations of their department and maintain a healthy life outside of work. Burnout from this stressful environment is a common problem. Who do they turn to for relief? They need to turn to themselves first! Self-care is a requirement, not a luxury. Resiliency knowledge and techniques provided in this presentation will help OR leaders stay healthy and committed to doing excellent work.
This session will present a case study surrounding the creation of an OR-specific supply chain program, including a case cart program that replaced a labor-intensive, department-centric surgical case pick process in an academic medical center. An overview of the rationale for the decision, the development for the business case, planning and implementation methodologies, and return on investment will be presented.
For the new or seasoned OR manager, understanding business operations and supply costs is a major part of managing monthly budgets. It is important to recognize which key data points will help you understand month-end variances. Understanding this data and having accurate reports at your fingertips will enable you to standardize and maximize two of your most valuable assets: real-time clinical and financial information. When used correctly, this information will result in increased efficiencies and lower costs. Sample reports and practical tips will be provided.
Learning objectives
• Acquire useful tools to gain clarity in understanding OR budget variances.
• Identify key elements of the item master and charge master.
• Recognize how deviations in surgical block time utilization will affect the operational bottom line.
Record profits and consolidations among payers were seen in 2015 while many providers struggled to keep up with shifts in reimbursement. Technology has become central to medicine, and providers have begun to pivot from care of the sick to maintaining health in a population. As more data have become available to payers and providers, the healthcare model has changed, and so has the regulatory burden. Discover what you need to know about recent reimbursement, coding, and billing changes. Sample policies, regulatory analysis, and reference materials will be provided to ensure that you receive full and accurate reimbursement for the services provided at your facility every day.
Learning objectives
• Identify recent billing changes and develop a new billing structure.
• Discuss how payers are paying for Telehealth services.
• Discuss the impact of ICD-10 and new documentation requirements.
• Describe the impact of new reimbursement models.
Change in the healthcare setting is best managed by using a research-driven change model. But how do you know which change model to use? Not all change models work equally well for everything. The presenters have developed a change model that is flexible for all uses, and it gives OR leaders a template for change that will enable them to gain efficiencies and get the best results. This model, a combination of PDSA (plan-do-study-act) and project management, can be used for everything from building a new OR to starting a service line to writing a policy. It works as effectively for people projects as it does for bricks and mortar projects.
Learning objectives
• Discuss how to use a change model and template for enacting any change in the OR setting.
• Describe the pre-mortem, key stakeholder interviews, and PDSA for process or project changes.
• Evaluate the changes put in place with input from key stakeholders and adopt a change model that will prevent barriers.
The presentation focuses on the approach to organize the OR master schedule in relation to the bed capacity. Optimization algorithms demonstrate the possibilities in aligning the OR master schedule with bed capacity.
Learning objectives
• Understand the effect of the OR master schedule on the variability in bed demand.
• Identify ways to improve the OR master schedule in relation to the bed capacity.
• Describe the results of applying the methodology in Dutch hospitals.
This presentation will cover the calculation of block utilization and discuss several variations to fit an organization’s objectives. It will also discuss challenges in implementing a block policy that adequately safeguards OR time while maintaining surgeon satisfaction and ease of access.
Learning objectives
• Understand how block utilization is calculated.
• Demonstrate active and passive ways to improve block utilization.
• Review how to objectively assign surgeon blocks.
Successful supply chain initiatives are increasingly important for cost-effective healthcare delivery. Several strategies have been adopted to better manage the supply chain while ensuring that providers have the right products and services to meet expectations for high-quality patient care: a contracting module to identify product trends prior to ordering; a low unit of measure self-distribution and logistical support to cut inventory costs, incremental ordering, and turnover times; surgical implant management software; support personnel to test equipment preoperatively; and use of specialty physician assistants.
Learning objectives:
• Analyze the relationship between the supply chain and surgery services.
• Describe six non-traditional approaches to service and support of surgery caregivers.
• Discuss justification formula for transactional tradeoff’s in exchange for efficiency and stakeholder satisfaction.
Lean Six Sigma can be used to develop a service line-specific program, including shaping a program vision, identifying key stakeholders, and standardizing practice, outcomes, instrumentation, and preference cards. Streamline processes for vendors and products, and develop customized procedure packs, block time, and room setup.
Learning objectives
• Discuss key elements needed to start a service-specific service line.
• Describe necessary steps to sustain the program.
• Identify key elements needed for continuous quality improvement.
Building an optimal OR master schedule assumes that enough patients are available at all times to fill all the slots within the OR master schedule. However, at the operational level, the waiting list of patients to be scheduled becomes important.
Learning objectives
• Define patient groups.
• Discuss how to optimally assign patient groups to the slots within the OR master schedule.
• Describe rules of thumb to be able to plan better.
A case study of the operating room optimization project piloted at Mercy Hospital Washington and scheduled to be rolled out to 178 identified ORs in the Mercy System. The purpose of the project was to develop and implement a clinically led, operationally driven point-of-use solution for the OR designed to achieve maximum clinical, operational, and financial benefits.
Learning objectives
• Describe the business challenges that are driving the increasing importance of perioperative resource optimization.
• Identify how to engage various stakeholders (physicians, nursing, supply chain staff, central sterile, etc.) in helping to develop and implement initial changes.
• Discuss the process that was implemented at Mercy, starting with preference card management, as the key foundational component.
Sustaining the momentum for continued savings requires a strategic plan. Intermountain Healthcare’s plan over the past 3 years has focused on refining resources, such as reports, dashboards, an enhanced doctor preference card update process, and culture change. Empowering stakeholders, both physicians and staff, to understand how their choices impact patient costs saved our 22-facility system millions in 2013 and 2014. To sustain these savings, the ProComp team has partnered with the supply chain, gained the support of physician champions, and looking beyond surgical services for opportunities. This session will highlight lessons learned since implementing ProComp and will provide recommendations that can be implemented in any size facility or system.
Learning objectives
• Identify essential elements to include in reports and dashboards.
• Describe strategies successfully implemented in 2015 to continue saving.
• Describe future strategic plans for cost control and keep insurance premiums at an increase close to the general rate of inflation.
Lean methodology was used to improve staff satisfaction and coordination of care at the hospital’s Birchmount Campus. Disorganized supplies and equipment resulted in either overstocking or being undersupplied, and communication between surgical suites staff and the stores department was poor. Coordination of care was adversely affected, causing frustration among staff, delays in patient care, and workarounds for supporting departments. The staff reorganized the space using 5S principles to allow for a more conducive flow, minimized expiration of supplies, and improved reliability of supplies in the sterile core. This resulted in better matching of stock levels to activity (11% reduction in excess inventory), higher staff satisfaction scores (from 18% to 83%), and improved coordination of care, and there were no supply shortages after implementation of the new process.
Learning objectives
• Discuss Lean principles that improve efficiency and effectiveness of work environments.
• Describe how to implement a 2-Bin Kanban system in a clinical environment.
• Understand strategies to use in engaging staff in process improvement.
Changes in healthcare are putting a magnifying glass on the business operations of perioperative services. Labor expense, supply expense, revenue accuracy, volume growth, procedure mix, and capital needs are among the issues to consider each day. How do you prioritize these issues to ensure focus on the areas with the greatest return on investment (ROI)? Finding the right balance of resources spent on revenue integrity vs expense management, and between labor expense control vs supply management, is a daunting task. This session will provide tools for prioritizing to achieve maximum results, identify opportunities, engage staff and physicians, communicate to senior hospital and corporate leadership, and track results.
Learning objectives
• Learn how to apply data-driven analysis to create a prioritization checklist for the greatest ROI.
• Understand how to bridge the operational and cultural gap between perioperative services and finance, and how to work successfully in a matrixed environment.
• Obtain engagement and communication tools and the knowledge to use them effectively.
With an estimated 40% of total revenue generated by the operating room, decisions related to allocating OR capacity are critical to hospital profitability of the hospital and surgical suite efficiency. Most operating rooms have significant variation in daily surgical volume, surgeon self-interest, underutilization of blocks, and inconsistent block management practices. Many organizations have tried unsuccessfully to smooth the schedule and plan for unexpected daily volume variations. This session will present the strategy and methodology to successfully “get the right fit” for your OR.
Learning objectives
• Identify data analytics required to determine your capacity needs and right size.
• Develop tactics for effective partnerships with surgeons and surgeon accountability.
• Create a performance management culture through improved strategic alignment, effective governance, and performance measurement.
• Improve resource planning and resource allocation decision making.
Healthcare is ever changing, so we have embrace change as a challenge and opportunity, and maintain a positive work environment for the team. Positive teams have a positive impact on patient care, and satisfied patients tell others about their experience, which helps drive the bottom line. How do you keep your team positive when everything is constantly changing? The speaker led her team through an acquisition by the local health system, and she will draw on that experience to discuss key drivers that keep the workplace positive, with specific examples of team-building activities.
Learning objectives
• Develop key ideas to keep your workplace positive despite constant change.
• Review positive attributes of team members that lead to productive, efficient teams.
• Examine the elements of team development to break down barriers across departmental lines.
Using Lean technology to achieve and sustain improvements requires surgeons to be champions for continuous improvement. To engage surgeons to support those goals requires a surgeon champion who is valued as a clinical expert and passionate about improvement, resources from the organization to support the champion, consistent application of the scientific method, and an evidence-based approach to change. We sought to improve patient flow while providing high-quality care. Having a surgeon champion helped us improve OR case creation, checklist use, safety huddles, room utilization, first case starts, and standardization of supplies. We will discuss the methods we used to achieve these results.
Learning objectives
• Describe the pivotal role of surgeons for successful implementation of process changes leading to permanent improvements.
• Discuss the four key strategies essential to continuous surgeon engagement.
• Identify opportunities to accelerate Lean initiatives with the surgeon as champion.
Share a meal with your new found connections at the Dine Around Dinner on the evening of Tuesday, Feb. 23 for a stress-free and fun evening! We’ve picked out the hottest spots in town for your dining enjoyment. Upon checking in at the show, make a reservation with our Dine Around Ambassador at one of our spectacular restaurants. When dinner time rolls around, gather with your group and head over to the vibrant Westgate City Center for your evening out.
have made it possible to reduce intracase utilization, saving $16.8 million in 2013 and $43 million in 2014. This session will focus on the value of development teams.
Learning objectives
• Identify the key team composition and criteria for selecting a physician champion to lead effective change.
• Describe how the development team supports supply chain initiatives, such as new product selection and contract negotiations.
• Discuss development team-specific reports that provide specialty-specific cost and outcome data.
To share the application of LEAN methodologies, including process maps and root cause analysis tools such as fish bone diagrams, as they applied to the implementation of 43 recommendations from an external review completed in the Operating Room of a Canadian Paediatric Acute Care Hospital. The review was conducted by members of the operating room leadership team from a national and international children’s hospital, and related to staff utilization, leadership, involvement in decision making, support services, ARON standards, and communication systems. The integration of an internal hospital wide Daily Continuous Improvement Program was also leveraged and has yielded over 100 completed improvement ideas over the last year.
Learning objectives
• Gain an understanding of LEAN methods/tools that are most applicable in an academic hospital setting.
• Share examples of the application of tools to specific operating room recommendations and process improvement initiatives.
• Demonstrate appreciation of the successes and challenges of implementation
With the rapid release of new technology by many vendors—particularly joint, spine, and cardiovascular device suppliers—the business manager must have a process to control the introduction without limiting access. Using a formulary approach and adding key business terms to the purchase agreement will help. Several approaches to managing an implant formulary will be provided. Details on how to distinguish new technology from substantially equivalent technology will be outlined.
Learning objectives
• Learn the critical terms and conditions to add to your purchase agreements to manage the introduction of new products.
• Objectively distinguish new technology from new catalog numbers in order to manage your pricing and expense line.
• Understand the advantages and disadvantages of using a product formulary to manage product price and usage.
Inadequate pain management in patients who undergo endoscopic retrograde cholangiopancreatography procedures can lead to extended recovery time and length of stay in the postanesthesia care unit, decreased patient satisfaction, and additional costs. In the era of value-based purchasing, it can also pose significant challenges as nurses strive to improve the patient experience and decrease costs. Taking action to improve pain management must be a high priority because it affects an organization’s ability to obtain full reimbursement for the care provided.
Learning objectives
• Identify patients at risk for extended length of stay.
• Discuss the financial implication when patients stay in the postanesthesia care unit longer than necessary.
• Describe the significance of providing adequate pain control.
Many hospital leaders know they are coming up short in management of surgical services supply inventories. How much inventory is ideal to meet clinical department needs? How should processes for ordering and distributing supplies be organized to maximize productivity? Is the OR sufficiently organized to meet demand? How fast is inventory turning over? As hospitals search for ways to reduce costs and increase productivity to positively impact their bottom lines, greater attention is being paid to the large investments they are making in surgical services supply inventory and management.
Learning objectives
• Identify inventory control activities and performance levels.
• Assess the current level of technology application, usage, and effectiveness.
• Review best practices in inventory replenishment processes.
Lean principles along with robust data and analytics to guide decision-making for process and material flow helped reduce supply expenses in 2013 and 2014 at Barnes-Jewish Hospital in St. Louis, MO. Investing in team members and providing robust data to engage surgeons were key to success. Elevated leadership involvement and hospital-wide focus contributed to a changing culture regarding financial stewardship and a new product evaluation process. Intraoperative supply expense and outages have been reduced, and having readily available supplies has helped improve management of doctor preference cards, supply pack changes, overall supply utilization. Process changes, cost communication tools, and outcomes dashboards will be reviewed, and examples of supply savings on physician preference items will be shared.
Learning objectives
• Describe key surgeon engagement strategy and data support for effective supply cost reduction initiative and key outcomes.
• Describe supply management changes regarding logistics, utilization, and inventory control with key outcomes.
*Agenda subject to change