Deciding Surgery Room Allocations in a Hospital

32:03Recorded on 19 June 2018 at TU Eindhoven

Fran Batchelor(UW Health, USA)

Fran Batchelor is a Nursing Informatics Specialist who supports the surgical services at three of UW Health’s hospitals. She used process mining to analyze the flow of urgent and emergent surgical cases added to the schedule.

Synopsis

The first speaker at Process Mining Camp 2018 was Fran Batchelor from UW Health in the United States. Fran is a Nursing Informatics Specialist who supports the surgical services at three of UW Health’s hospitals. She used process mining to analyze the flow of urgent and emergent surgical cases added to the schedule. What did she find?

The operations for most cases are scheduled and planned well in advance. For these patients the room is being prepared and the patient is transported to the room and after the operation the patient is transported to the recovery room. At the hospital they have 27 operation rooms available.

There are other patients that require urgent care, for which additional ‘hold’ rooms are reserved. However, sometimes there are more emergent cases than available operating rooms, such that schedules need to be adjusted. The smooth flow is critical for emergent cases and the challenge is to allocate the operating space for these patients.

At the hospital, two additional operation rooms were to be opened for the emergent cases and a project was started to determine how these rooms could be best allocated. Neurosurgery had made a case for all available new space and was in line to receive it. However, Peripheral Vascular also voiced a need. A team was assembled to provide information regarding the decision making. How many add-on cases are there without a dedicated hold room being available? How are they moving through the process and are they still meeting the internal performance metrics?

From the database the team extracted the data for each step in the process and developed the logic to identify the add-on cases. By visualizing the process using process mining they were able to see how add-on cases behave. They were able to see that 70% of the cases were scheduled and of the 30% unscheduled cases 12% didn’t have dedicated hold rooms.

When looking at the flow of the add-on cases, they realized that not all cases have the same urgency. By giving the cases a priority, they were able to distinguish between the different levels of urgency. Especially when focusing on the emergent cases of Neurosurgery and Peripheral Vascular they found that 43% of the cases that took longer than 1 hour to get to the operating room belonged to the Peripheral Vascular surgery (a higher volume compared to Neurosurgery). So, it was most logical to allocate the additional rooms for both of these procedures.

Process mining reduced the political and emotional components when taking these decisions. By looking at the data and the visualization it was possible to tell the story more easily. Without process mining it would not have been possible to make such a clear-cut case and the decision would have been made differently.

However, it was not easy and took two years to get to this point. First of all, it was a challenge to set up the project and get access to the right data. Secondly, they needed to develop the sponsorship to develop the capability to apply process mining and drive the project.

Fran was able to overcome these hurdles by being persistent, handpicking the right team, selecting a project scope for which the complexity was manageable, and by ensuring that the surgical leadership was involved in leading the project.

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