At Baptist Health Jacksonville, Pursuing Hyper-Efficiency in OR Management

Using advanced analytics to propel hyper-efficiency and hyper-effectiveness in hospital operations has long been an aspiration of ambitious hospital and health system leaders. But figuring out where to start and how to pursue efficiency and effectiveness initiatives remains a challenge, given the complexity of hospital operations.

As Gartner’s November 2021 report on “Emerging Technologies and Trends Impact Radar: The Real-Time Health System,” points out, “[Healthcare providers] recognize and understand well the value of optimizing patient flow and managing capacity. Managing patient throughput and the utilization of facilities, staff, and materials are persistent hospital operational and strategic priorities that underlie most cost-optimization initiatives.”

One integrated health system whose leaders appear to have cracked the code, in a key operational area, is the Jacksonville, Florida-based Baptist Health. As a large, complex, and busy integrated delivery network with five hospitals, 74 operating rooms, and approximately 47,000 surgeries annually, senior leaders at Baptist Health wanted to increase the utilization of their health system’s operating (OR) suites. The organization’s existing OR scheduling software lacked predictive capabilities and clinician engagement features, so surgeons had difficulty finding and reserving ORs even when prime time utilization was low. Leadership also wanted to improve data on utilization and equipment needs before making important decisions on capital requests for new facilities and robotic equipment. To address the set of challenges facing them, Baptist leaders decided to partner with the Santa Clara, Calif.-based LeanTaaS, Inc., which describes itself as “a market-leading Silicon Valley-based technology innovator that transforms core processes to improve patient access and operational performance.” Baptist Health’s leaders have been working with LeanTaaS professionals to implement and expand a predictive and prescriptive analytics platform that optimizes access to scarce OR capacity.

In a press release issued last month, Amy Cate Huveldt, vice president of performance excellence at Baptist Health, said that “Engaging LeanTaaS was an important step in improving OR utilization throughout Baptist Health hospitals/ We received real, worthwhile results from our investment in LeanTaaS and alignment of people and processes. Improving our OR operations translates to surgical growth, engaged providers, and improved patient care, all of which are helping us achieve our organizational goals.” And that press release quoted Ashley Walsh, vice president, client services for iQueue for Operating Rooms, the division of LeanTaaS working actively with the Baptist team. “We have a truly collaborative relationship with Baptist Health, and we’re thrilled to see iQueue for Operating Rooms featured as a use case in a Gartner Case Study,” Walsh said. “We’re continuously working to provide our health system customers with the capacity optimization solutions they need, and it’s that clear access to valuable, actionable data that improves both the patient and provider experience. Baptist Health is proof that an investment in operational excellence is a win for clinicians, patients, and the bottom line.”

Last month, Huveldt, who has spent nearly 12 years altogether at Baptist Heath, including six years in the VP of performance excellence role, spoke with Healthcare Innovation Editor-in-Chief Mark Hagland regarding the OR efficiency initiative and what’s been learned on that journey so far. Below are excerpts from that interview.

Can you tell me about your personal-professional background?

I’m an engineer; got my BS in industrial engineering, and executive MBA.

How did you and your colleagues decide to focus on the area of OR room utilization?

We’re a small team who focus on Lean and operational efficiency. And the OR is obviously a good idea to look. Room turnover, on-time starts, other key metrics. Our former COO had heard about LeanTaaS, and Baptist MD Anderson was using them in their infusion center, you should check it out. So we met with the LeanTaaS people, and started implementing at one of our hospitals in October 2019, and then quick rolled out, even during COVID, and implemented in our last surgical center in February 2021. We have five hospitals, one is a children’s hospitals. We’re planning to open another hospital in the near future.

What is at the core of the OR utilization initiative?

What iQueue does for us is that it brings analytics and insights into the OR. Their platform makes it so much easier to see where we have openings, how long, and who with. It’s like OpenTable for the OR. Not everybody gets equivalent blocs, and we’ve got lots of new surgeons coming into Jacksonville, it’s a booming part of the country. Or if a surgeon knows they’ll be out for a conference, we can reclaim their time. That was the genesis of the initiative, and it really gave us great reports to bring to our committees. We decreased abandoned blocs by 22 percent straightaway. And our utilization went up 16 percent right away, 17 points over the prior year. We need to recapture every minute we can in our ORs.

How does this fit into that overall quest for hyper-efficiency?

It totally supports that effort. You can’t fix what you can’t see and measure. This gave us believe time stamps to give to the surgeons. They know the data is real. It’s believable and accurate. And it gives us immediately actionable data. So this totally supports that. And, tangentially, during COVID, when we had to close our elective cases, iQueue was able to collaborate with us—things were somewhat chaotic—which surgeons were able to take cases and not, so this gave us a communication platform as well.

Surgeries were still taking place that were not elective during that time, correct?

Yes, we had to keep taking care of patients. And so the canceling and rescheduling of elective cases, iQueue was critical in that work.

Were there any challenges in setting this up?

The first part was simply selling this, and making sure you got the buy-in. And the first part of any change management involves getting buy-in. Our hospital presidents were on board; start with your leaders. And the LeanTaaS were willing to come out in person.

Did you need surgeon champions in each facility in order to move this forward?

It’s always a good thing to have; there will always be one or two people who don’t want change. So yes, you should definitely have physician champions, and we did have champions.

What kinds of process learnings have you gleaned?

One very important learning has been around definitely getting the stakeholder buy-in: get into the weeds. Say, this is taken from Cerner, now Epic. Show them what the data is, what it means, the expectations. And show them it will be a driver of decision-making. And having a surgeon champion and the support of the hospital president. And you find things out that are surprising in terms of things like utilization. And once you’ve got the buy-in, it’s hard to argue. And my team got this set up, in concert with others. And when we were in the control phase of the project, people said, we really need you! So when you get to the point that people are asking for the information, you know you’ve crossed a threshold.

What should health IT leaders know?

I didn’t hear a lot of static about this; it wasn’t that complex. And we just went through our Epic implementation; and I heard, thank goodness we had iQueue, because there were hiccups, and we might have been flying blind for a bit.

Going forward, will you and your colleagues be making any changes to the program, or will you more or less continue it forward as it is?

One thing we’re using iQueue for now is to look at our robotic utilization. Robots are a great surgeon satisfier, but they cost money and take longer to do the cases. We’ve got to be thoughtful. It feels like we need more robots, but we need to be cautious. We’ll get back to you on the number. Urology and gynecology are big in that regard. They help the surgeon to be more precise. The robot is able to make the surgery more precise. These include DaVinci robots.

Do you have any final thoughts or advice for our readers?

Definitely get your administrative, surgical, and anesthesiologic leaders, get their buy-in; and don’t be afraid to try this; it’s definitely been worth the ROI, for sure.