The surgical scorecard: a tool to close the loop on OR utilization.

OBJECTIVE

Operating room (OR) suites are among the highest cost- and highest revenue-generating areas in most hospitals. A scorecard containing utilization and performance metrics for each surgical service and surgeon was designed by the OR leadership with results sent monthly to each surgical chief. Recent trends reveal an increased focus on optimizing utilization of OR resources as part of institutional cost-analysis efforts. Protected block time into which elective surgical and procedural cases can be booked must be used appropriately and booked fully to offset the fixed costs of staffing and running the OR.

DESIGN AND SETTING

The intent of the scorecard tool was to provide detailed information on utilization of protected block time for performance-improvement planning. First-case on-time start was also measured and reported so that block time at the start of the day was fully utilized. With the granular information on time-use performance of each surgeon, the surgical chiefs were able to make workflow changes to improve utilization of staffed prime-time block hours. The scorecard tool is used ultimately for communication, not calculation, of utilization metrics. MEASUREMENTS AND CONCLUSIONS: Block-time utilization was measured both before and after the implementation of the scorecard. The analysis of the period before and after implementation of the scorecard revealed an improvement in block-time utilization in all but 1 surgical service.