1. OPERATING ROOM DASHBOARD Virginia Chard, RN, BSN, CNOR
Pen Bay Medical Center
Rockport, ME

2. Today’s Healthcare Challenges
It’s a new day in how we deliver and how we are paid for delivering patient care.
Healthcare reform has brought new strategies, processes, and innovations to the table.
Affordable Care Act
Accountable Care organizations
Meaningful Use
Value Based Purchasing

3. New emphasis going into the future:
Quality
Performance
Accountability
Efficiency

4. What this means for the Us
New strategies for efficiency, cost containment, revenue enhancement
New funding- pay for performance, bundling
Improved utilization of space, time, human resources

5. Strategic Plan Our overall mission:
Offer safe, highest quality patient care and customer service to our community
Increase patient, surgeon, staff, and anesthesia engagement and satisfaction
Create potential for new business opportunities

6. The Journey
Engaging the executive Team in our plans and expected outcomes
Defining the key stakeholders and their roles in the process
Identifying needed resources (i.e. IT) to support the data gathering
Developing a format to present the data in a consistent, concise package
Building communication channels to share our data and move our goals forward as a team

7. Who owns this journey? Identify Stakeholders: Executive team members
Medical Director
Chief of Surgery
Chief of Anesthesia
Surgical Director
Department Managers-OR/SPD, PREP, Surgical Care
Front line staff

8. Facts of data management
Most health care facilities and operating rooms maintain databases and generate dashboards that help the management evaluate its performance; Multiple genre of data has been collected in perioperative service:
Clinical outcome: e.g. Surgical Care Improvement Project (SCIP) measures
Institutional initiatives: e.g. patient satisfaction rate
Risk management data: e.g. medication errors
Operational efficiency: e.g. first case on-time start
Financial performance: e.g. supply cost/ case

9. The Game Plan Assessment of where we are
Team Collaboration across all disciplines
Education and Communication
Stakeholder ownership and involvement
Development of key performance indicators
Process changes identified
Implementation of identified changes
Sustainability

10. Where We are

11. Stakeholder Participation

12. Education/Communication

13. Ownership/Involvement

14. Key Performance Indicators
Monitor and improve turn around times
Monitor and improve first case start times
Monitor and improve/right size block utilization
Monitor and improve booking accuracy

15. The Surgical Dashboard
Why
To report surgeons’ operational and financial performance
To maximize block utilization
How
Retrieve data from ORIS, preference card, supply chain master item file to generate the comprehensive report
What
Surgeon scorecards satisfy the needs of block management and present the complete picture of surgeon performance related to OR operations
Key Performance Indicators are in line with OR performance dashboard, e.g. case volume, first case on time start
Block utilization, out-of-block surgery minutes
When
Monthly report for review and report
Quarterly report for OR leadership’s decision on block reallocation

18. Data Management Challenges in OR:
Data accuracy
Many ORIS do not provide data-cleansing functionality - “Garbage in garbage out”
Accurate, complete data is essential to an effective performance dashboard
Analytical skills and experiences in OR data management
DRIP – Data Rich Information Poor
Let the numbers speak, “gut-feeling” is not always right
Buy-in of surgeons and clinicians
Data and information needs to be presented in an intuitive and informative manner
Increase data transparency and data sharing with clinicians
Culture change
It takes time for data-driven decision making to Gain Ground in hospital and perioperative management

19. The Tools

20. PBMC Surgeon Utilization Report

21. PBMC Surgeon Utilization Report
Reserved Block Minutes Use

22. PBMC Surgeon Utilization Report
Minutes in Regular Hours
Estimated vs. Actual Minutes
First Come, First Served Minutes

23. PBMC Surgeon Utilization Report
Day Surgery
Emergency Minutes In/Not In Regular Hrs

24. Dashboard detail –specialty group block time

26. First Case Start Time
First case start is defined as the time the first scheduled patient of the day enters the OR
On time is defined as patient in the room by 0735 or within 5 minutes of scheduled start time

27. Detail

28. First Case Starts

29. Turn Around Times
Definition of Turn Around Time: Patient out of the room time to patient into the room time

31. Turn Around Times

32. OUTCOMES
A centralized standard report depicting a complete picture of OR operational performance
A continuous measurement mechanism demonstrating performance trend
An effective tool helping identify performance improvement opportunities
An intuitive communication venue facilitating decision making process

33. The rest of the story Turn Around Time – Initial average 27 minutes
Current Average 22 minutes
First Case Starts-
Initial performance average- 62%
Current performance average- 81%
Results achieved by collaborative changes in processes by surgeons, surgical staff and Anesthesia

34. Block Utilization
Work is ongoing as we develop communication mechanisms to keep surgeons informed of OR utilization and their individual performance within their blocks Several successful changes have already been implemented to support block utilization and efficiency

35. Questions???