Surgical Services and Surgery Management Consulting

Given the increased demands for efficiency to extend operating room (OR) capacity and for improved OR financial performance at this academic medical center (AMC), the medical center’s leadership engaged ECG to conduct a focused review of the operating and financial performance of the ORs. We worked closely with faculty and medical center leadership to confirm and prioritize the operational and financial issues, and perform intensive data analysis on key operating and financial metrics, such as service-specific utilization and physician- and procedure-specific case lengths and contribution margins. Resulting from this engagement were specific tactics for realigning management authorities, improving on-time starts, reducing day-of-surgery case cancellations, and increasing OR capacity.

This academic medical center's (AMC’s) leadership engaged ECG to assist with developing a framework for improving the organization and management of the operating rooms (ORs). As part of this engagement, we surveyed other health systems and AMCs regarding surgery organization and management best practices, and worked with faculty and medical center leadership to define a revised OR organizational structure, as well as OR management roles and responsibilities for anesthesiologists, surgeons, and medical center leadership. As a result of the engagement, the AMC implemented the revised organizational structure, leadership roles and responsibilities, and OR management policies and procedures.

To address physician concerns and satisfaction with surgical services operational performance, ECG assisted this medical center with assessing its inpatient and outpatient surgical operations. This comprehensive engagement included analysis of leadership and management, key operational statistics (e.g., room utilization, room turnover, on-time case starts, case cancellations), patient and work flows, and IT capabilities. As a result of this engagement, the medical center restructured the department’s leadership and decision-making authorities and instituted an OR committee to implement the operational recommendations in our action plan.

As a result of the persistent closures of operating rooms (ORs) due to a lack of anesthesia coverage, this AMC engaged ECG to develop an anesthesia staffing plan that would allow the facility to meet its surgical patient load. The development of the plan included assessing all facility requirements for anesthesia; understanding the surgical block schedules, work flows, and variable demands of the OR; and evaluating alternative sites of surgical service. As a result of the revised anesthesia staffing plan and streamlined work flows, the ORs improved operating capacity and resolved the limitations imposed by anesthesia services.