Perioperative process flow and analysis of factors affecting efficient delivery of surgical schedule

With continuously increasing cost of healthcare and competition among hospitals to deliver quality services in an efficient manner, healthcare organizations are under constant pressure to maximize the use of available resources in the most cost effective manner and improve efficiency and productivity. Even though Operating theatres are of pivotal importance to hospitals as they are the biggest revenue and cost centers and most of the hospital admissions are caused by surgical interventions, recent studies have shown that Operating Room performance measures are far behind achievable targets (Denton et al., 2007). Thus, improving productivity and utilization of Operating Room (OR) resources is a key objective for hospitals. Implementing system-wide process improvement in perioperative environment is challenging as hospitals are highly complex systems and perioperative process flow requires coordination of various stakeholders having their specific roles and responsibilities for a diverse mix of surgical cases and patient needs. Adding to it is the inherent randomness and also the fact that hospital administration are typically designed around organizational groups thus promoting functional silos having individualized and conflicting incentives (Girotto et al., 2010) and challenging information flow. Monitoring and analyzing patient flow is the most critical part of managing or eliminating variability (Dempsey, 2009). Exploratory research methods are usually used in social science research for a problem that has not been clearly defined. Thus, this exploratory case study focused on detailed study of patient flow through the perioperative process of a general purpose unit including 6 functional operating rooms. From the extensive data analysis, detailed study of patient flow and semi-structured interviews conducted with different stakeholders of the hospital management, I comprehend that that a systems perspective of the entire perioperative process flow instead of myopic activity level approach is necessary to solve the OR management problem and also list out factors impacting perioperative process flow.