Introduction of an Operating Room Information Management System Improved Overall Operating Room

Efficiency

Cathy S.I. De Deyne, MD, PhDDept of Anesthesia and Critical Care Medicine

Ziekenhuis Oost-LimburgGenk (Belgium)

cathy.dedeyne@ZOL.be

Total OR activity costs

Every minute of OR time used or un-used is the main determinator

Every available minute of OR time should be optimally utilized in order to guarantee optimal OR utilization

Efficient use of OR time is thé major factor of total OR activity costs

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OR information systems

optimal OR efficiency by optimal utillization of every available OR time

1. Centralized electronic scheduling of OR procedures

1. Daily management of OR activity

1. Posthoc evaluation of OR activity by analysis of all registered data in balanced scorecards

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Introduction of an OR Information Management System

Operating Room Scheduling and Management Information System

Since january 2001 ZOL : 16 operating theatres / 3 different locations

ORM-m : part of the Yuse Matrix Box = integrated cross-department software package for hospital’s primary care processes

ORM-m : 3 major parts

1. Centralized electronic scheduling of all OR procedures2. Daily management of all OR activity3. Posthoc balanced scorecards

cdd/2004.11

Introduction of an OR Information Management System

Operating Room Scheduling and Management Information System

Since january 2001 ZOL : 16 operating theatres / 3 different locations

ORM-m : part of the Yuse Matrix Box = integrated cross-department software package for hospital’s primary care processes

ORM-m : 3 major parts

1. Centralized electronic scheduling of all OR procedures : OR Planner 2. Daily management of all OR activity3. Posthoc balanced scorecards

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WHEN CLICKING ON WHEN CLICKING ON PROCEDURE BLOCKPROCEDURE BLOCK

Introduction of an OR Information Management System

Operating Room Scheduling and Management Information System

Since january 2001 ZOL : 16 operating theatres / 3 different locations

ORM-m : part of the Yuse Matrix Box = integrated cross-department software package for hospital’s primary care processes

ORM-m : 3 major parts

1. Centralized electronic scheduling of all OR procedures2. Daily management of all OR activity : “airport-like screen”3. Posthoc balanced scorecards

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BLUE + WHITE BLUE + WHITE

SCHEDULED SCHEDULED PROCEDUREPROCEDURE

BLUE + BLACKBLUE + BLACK

NONONN SCHEDULED SCHEDULED PROCEDUREPROCEDURE RED RED

URGENT URGENT PROCEDUREPROCEDURE YELLOWYELLOW

INFECTED INFECTED PROCEDUREPROCEDURE

EXAMPLE OF CONTINUOUSLY UPDATED OR SCHEDULE (Friday 16 February 2001 at 9.00hr)

….. Friday 16 February at 13.00hr

….. Friday 16 February at 14.30 hr

Monday 23 October : EXAMPLE OF DYNAMIC RE-SCHEDULING

OR PROCEDURE SCHEDULED IN ROOM 1 MOVED TO ROOM 8

DYNAMIC RE-SCHEDULING FROM ROOM 3 TO ROOM 6

Introduction of an OR Information Management System

Operating Room Scheduling and Management Information System

Since january 2001 ZOL : 16 operating theatres / 3 different locations

ORM-m : part of the Yuse Matrix Box = integrated cross-department software package for hospital’s primary care processes

ORM-m : 3 major parts

1. Centralized electronic scheduling of all OR procedures2. Daily management of all OR activity3. Posthoc balanced scorecards

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TOTALE ACTIVITEIT 2001-1 : 10743 ingrepen

4982

3955

1806

ZG

ZW

ZL

5369

3755

2395

TOTALE ACTIVITEIT 2001 - 2 : 11519 ingrepen

Total OR activity / campus 2001 (1-2)Total : 22 262 procedures

Block-Occupation (scheduled) ZG 2001-1mean occupation : 95.7%

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Room 1 2 3 4 5 6 7 8

Day

MONDAY CTV CTV ORT NCH ABHK/ CAHK GYN MKA

97%97% 94%94% 91%91% 121%121% 129%129% 105%105% 84%84% 87%87%

TUESDAY NCH /URO ORT NCH ABHK CAHK GYN PLHK

106%106% 83%83% 98%98% 112%112% 109%109% 124%124% 95%95% 76%76%

WEDNESDAY CTV CTV ORT NCH AHK/URO CAHK GYNGYN

111%111% 98%98% 94%94% 100%100% 56%/84%56%/84% 88%88% 90%90% 96%96%

THURSDAY GYN/ ABHK ORT NCH ABHK CAHK GYN MKA

69%69% 94%94% 92%92% 111%111% 88%88% 119%119% 85%85% 84%84%

FRIDAY CTV CTV NCH NCH ABHK CAHK GYN MKA/GYN

112%112% 98%98% 107%107% 101%101% 96%96% 90%90% 90% 98%/85%90% 98%/85%

Block-Occupation (scheduled) ZG 2001-1mean occupation : 95.7%

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Room 1 2 3 4 5 6 7 8

Day

MONDAY CTV CTV ORT NCH ABHK/ CAHK GYN MKA

97%97% 94%94% 91%91% 121%121% 129%129% 105%105% 84%84% 87%87%

TUESDAY NCH /URO ORT NCH ABHK CAHK GYN PLHK

106%106% 83%83% 98%98% 112%112% 109%109% 124%124% 95%95% 76%76%

WEDNESDAY CTV CTV ORT NCH AHK/URO CAHK GYNGYN

111%111% 98%98% 94%94% 100%100% 56%/84%56%/84% 88%88% 90%90% 96%96%

THURSDAY GYN/ ABHK ORT NCH ABHK CAHK GYN MKA

69%69% 94%94% 92%92% 111%111% 88%88% 119%119% 85%85% 84%84%

FRIDAY CTV CTV NCH NCH ABHK CAHK GYN MKA/GYN

112%112% 98%98% 107%107% 101%101% 96%96% 90%90% 90% 98%/85%90% 98%/85%

Aim of this report

Comparison of “performance” or “efficiency” of all OR activity for elective abdominal surgery for 2000-1 to 2001-1

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Aim of this report

Comparison of “performance” or “efficiency” of all OR activity for elective abdominal surgery for 2000-1 to 2001-1

No urgent or semi-urgent procedures : only scheduled procedures

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Aim of this report

Comparison of “performance” or “efficiency” of all OR activity for elective abdominal surgery for 2000-1 to 2001-1

No urgent or semi-urgent procedures : only scheduled procedures

2000 2001

Total available OR time 805h 805h

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Aim of this report

Comparison of “performance” or “efficiency” of all OR activity for elective abdominal surgery for 2000-1 to 2001-1

No urgent or semi-urgent procedures : only scheduled procedures

2000 2001

Total available OR time 805h 805h

Operative procedures 764 815

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OR activity for elective abdominal surgery for 2001-1

6.6% increase in number of performed procedures

At what expenses ???

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OR activity for elective abdominal surgery 2000-1 compared to 2001-1

Aim of this report

Comparison of “performance” or “efficiency” of all OR activity for elective abdominal surgery for 2000-1 to 2001-1

No urgent or semi-urgent procedures : only scheduled procedures

2000 2001

Total available OR time 805h 805h

Operative procedures 764 815Total duration of OR procedures 1044h50min 1127h35min*Total excess time 147h20min

123h04min*Total unused time 46h45min 35h21min*

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OR activity for elective abdominal surgery for 2001-1

6.6% increase in number of performed procedures

At what expenses ???

-16.3%* excess OR time

excess time defined as realized OR time exceeding the normal limits of OR activity, and inducing extra costs for nursing staff

normal OR time at our institution : 8.00 AM to 4.30 PM

excess time : OR time > 4.30 PM

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OR activity for elective abdominal surgery 2000-1 compared to 2001-1

OR activity for elective abdominal surgery for 2001-1

6.6% increase in number of performed procedures

At what expenses ???

-16.3%* excess OR time -23%*unused OR time

unused OR time defined as OR time during normal activity hours without any procedure performed

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OR activity for elective abdominal surgery 2000-1 compared to 2001-1

OR activity for elective abdominal surgery for 2001-1

6.6% increase in number of performed procedures

At what expenses ???

-16.3%* excess OR time -23%* unused OR time

INCOME > > > EXPENSES increased OR performance

How to explain ???

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OR activity for elective abdominal surgery 2000-1 compared to 2001-1

-23%* unused OR time

significant reduction in turnover time (time between patient

OUT and next patient IN)

2000 m12.3min2001 m7.8min*

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How to explain increased OR performance by introduction of an OR information

Management System ?

-23%* unused OR time

significant reduction in turnover time (time between patient OUT and

next patient IN)

2000 m12.3min2001 m7.8min*

possibly due to a reduction in arrival time to OR?

2000 m21.3min2001 m14.1min*

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How to explain increased OR performance by introduction of an OR information

Management System ?

….. Friday 16 February at 13.00hr

“management’” of all information

• OR planner open to electronic surgical bookings

• Management of all scheduled information

• Management of patient medical data ànd materials

• Readily accesible availability of all medical information

• Management of OR activity during daily practice…..

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How to explain increased OR performance by introduction of an OR information

Management System ?

DYNAMIC RE-SCHEDULING FROM ROOM 3 TO ROOM 6

Introduction of an OR Information Management System

Operating Room Scheduling and Management Information System

1. Centralized electronic scheduling of all OR procedures

2. Daily management of all OR activity3. Posthoc balanced scorecards

increased performance of OR activity, with more procedures performed despite less expenses

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