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From the August 2003 Issue Stanching Hospitals' Financial Hemorrhage With Information Technology |
Smooth Flow Technology helps Midwest healthcare network avoid OR scheduling conflicts.
Disparate Systems Evanston Northwestern Healthcare operates three hospitals, 22 operating rooms, four outpatient treatment centers, physician offices, cath labs and GI labs. In 2000, Evanston’s different OR systems, SurgiServer and ESI, prevented them from managing supplies and surgery schedules centrally. By using SurgiServer at two facilities (Evanston and Glenbrook) and ESI at the other (Highland Park), the healthcare system maintained two databases and DOS systems. What’s more, the systems were not integrated, and excess staff time was required to try to keep schedules and records up-to-date. These inefficiencies contributed to more than 15,000 surgeon preference cards between the sites. Updating records was labor-intensive and slow, and it contributed to inefficient scheduling and inaccurate supply data throughout the organization. For example, if staff wanted to order one surgical pack for a laparoscopic cholecystectomy procedure (laparoscopic gall bladder removal) instead of 15 individual items, there was no global way to cross-check the three sites to identify who performs this procedure and to update surgeon preference cards automatically. A staff member had to access each individual physician preference card, remove the old items and add the new supply. This procedure was required for 20 surgeons for up to five procedures each, at three sites, and resulted in a backlog of requests. Clinicians became so frustrated with delays that they stopped suggesting ways to improve and cut costs. Booking and managing OR time was a slow, error-prone process that required repeated phone calls and excess FTEs in each facility, since there was no shared scheduling among all sites and remote physicians’ offices. Staff would call Evanston Hospital to book cases for Evanston and Glenbrook hospitals according to scheduling information found on the grid via the SurgiServer system. But when someone from Evanston or Glenbrook wanted to schedule cases at Highland Park, it required a phone call to Highland Park directly. Remote physicians had no way of knowing what time slots were available, so their office staff had to call each facility to book OR time or make changes. Single Solution In 2000, Evanston sought a single OR management solution that would integrate its facilities, provide centralized and remote scheduling and report across sites. Annette Dopp, director of perioperative services, led the search for the replacement system. Dopp and her colleagues looked at all the major vendors in the market and collected information from exhibitors at the Association of periOperative Registered Nurses Congress. They scheduled product demonstrations, conducted site visits and ultimately chose OR Manager by Wakefield, Mass.-based Picis because of the system’s user-friendliness, Windows-based interfaces, multifacility capabilities and the ability to link to industry-standard reporting tools such as Microsoft Excel. Once selected, Picis and Evanston worked quickly to install the system within four months. The schedulers trained on-site for two days and adapted quickly once they learned how to use a Windows-based system. On Feb. 1, 2001, all three facilities went live with the complete perioperative information system, replacing the existing systems. At the same time, Evanston switched to a new materials management system from Lawson Software, requiring 89,000 line items of material data to be cleaned up and included in the Picis system. This was accomplished for the go-live date. Smooth Results The Picis solution has helped improve Evanston’s business significantly. Evanston has redirected staff time, reduced supply costs and increased efficiency across all sites. The organization has reduced the time spent on scheduling by implementing centralized scheduling with one team instead of using schedulers at all three hospitals. Centralized schedulers now book cases at all three sites and check conflicts among them without picking up the phone. Automated conflict-checking eliminates duplicate bookings and simplifies sharing of resources by preventing the same surgeon, patient or piece of equipment from being booked simultaneously at another site. The system also factors in travel time between sites, increasing the accuracy of schedules and maximizing OR time. For example, if a surgeon has a morning case at Glenbrook and tries to book a case at noon at Evanston, the system won’t allow the second case to be scheduled without taking into account the 30-minute drive between these two facilities. Six months after the go-live, Evanston implemented remote scheduling at its physicians’ offices, which have expanded to 50 users. Remote physicians connect through the hospital intranet and book directly into the scheduling grid. This added service has reduced phone calls and enables appropriate personnel to book surgeries at their convenience. Staff now spend less time on the phones and more time on billing, in an effort to increase revenues. This multifacility implementation also allows Evanston to compare apples to apples because of standardization and integration between its sites. The standardization of supplies has made case-costing possible and helps Evanston staff make sure that patients are receiving the same standards of care no matter where a procedure is performed. Moreover, standardization has helped Evanston consolidate 15,000 physician preference cards down to 1,000 and has made automated updates fast and easy. Evanston’s hospitals share the same master procedure list and use generic preference cards for building supply needs. The process of updating 20 surgeon preference cards previously would have taken hours, but now it can be accomplished in less than five minutes. Dopp says costing data from the OR system helps educate staff on improved practices. Dopp took data from the Picis system into Excel and graphed laparoscopic cholecystectomy costs by physician. The data collected showed that supply costs for this procedure ranged from $300 to $1,200 depending upon whether the surgeon used reusable endoscopic equipment or more expensive disposable items. Evanston reduced its average supply costs for this procedure to about $500 by sharing this performance data with surgeons. Dopp says Evanston now has a tool that can help the healthcare network get ahead in a competitive market by helping improve both the clinical and administrative operations of OR management. SOURCE Annette Dopp, R.N., B.S.N., C.N.O.R. PRODUCT/COMPANY
For more information about OR Manager from Picis, www.rsleads.com/308ht-201 © 2003 Nelson Publishing, Inc |
In most integrated delivery
networks, a successful surgery department often depends on multifacility integration to minimize waste, improve accuracy and streamline services. Disparate operating room management systems at Evanston Northwestern Healthcare, a three-facility organization in the Chicago area, hampered efforts to improve staff satisfaction and the business side of its surgery department—until the healthcare system implemented one integrated solution.
OR Manager