"Part of the challenge was the inability to have flexibility in the schedule," she says. "For example, you start your day with 10 scheduled surgeries and you have 10 anesthesiologists, one per room, and then you have an urgent add-on. In a traditional model, you'd have to bump a surgeon."
In part, that flexibility has increased efficiency in the OR, and now surgeons encounter fewer delays and fewer cancellations. The move has also increased revenue and margin from additional cases that can be added. The hospital is getting higher surgeon and patient satisfaction scores, Lilley says, and volume has increased. Now, CRNAs can get cases going so there's no bump in the surgical schedule when add-ons come in.
To do so, the anesthesia team created what Lilley calls a "flip room concept," which consists of a team of nurses who can move from room to room so that "the surgeon talks to the patient, sees the family, and then goes into the next room for the next patient, reducing the amount of time between cases," she says. "What that has done is compressed the schedule so we're pretty much done in the OR around 7:30 at night."
Previously, they had to work until 11 p.m. or midnight.
Now, with more anesthesia providers available at any given time, Lilley says, "if there's a code in the house or if an anesthesia provider is needed in endoscopy or cath lab or if someone comes in emergently, we have the capability of sending anesthesia providers to those areas and not affect the OR," she says. "From a customer service point of view, surgeons don't see any bumps."
Philip Betbeze is senior leadership editor with HealthLeaders Media. He can be reached at firstname.lastname@example.org
This article appears in the March 2013 issue of HealthLeaders magazine.