She adds that this question gained traction under the prospect of healthcare reform, where efficiency and quality is rewarded.
"We shouldn't put more into plants and operations than we need to."
That meant some extensive process re-engineering was in order.
St. Luke's is one of 14 hospitals (and three medical schools) which make up some of the 49 healthcare institutions that are part of the largest collection of clinical space in the world—Texas Medical Center in Houston. Even though the system has plenty of space for expansion outside the central downtown location of TMC, options for replacement and expansion are limited on the TMC campus. That forced them to make the necessary decision to improve processes to get more out of the space they already have, says Van Bree.
GE Healthcare Performance Solutions was brought in to consult about ways to optimize the space and time constraints at the hospital. The project, as you might guess, is heavily populated by physicians, who found their time spent at St. Luke's was less productive than it might be. Though there are lots of components in the exercise, big gains stood to be made by doing a better job of patient care management and block scheduling for the physicians, Van Bree says.
"Some of the initial work has been on smoothing out variability in the elective operating room," she says. "It's six times greater than in our emergency room."
Physicians there preferred the first come, first served nature of scheduling elective surgeries, she said, but that wasn't working very well at St. Luke's—even with 42 total ORs available. Implementing block scheduling, which allows them to do several cases in one block of time, wasn't perfect either.