1. Introduction of an Operating Room Information Management System Improved Overall Operating Room Efficiency Cathy S.I. De Deyne, MD, PhD Dept of Anesthesia and Critical Care Medicine Ziekenhuis Oost-Limburg Genk (Belgium) cathy.dedeyne@ZOL.be

2. Total OR activity costs  Every minute of OR time used or un-used is the main determinator  Every available minute of OR time should be optimally utilized in order to guarantee optimal OR utilization  Efficient use of OR time is thé major factor of total OR activity costs cdd/2004.11

3. OR information systems  optimal OR efficiency by optimal utillization of every available OR time 1. Centralized electronic scheduling of OR procedures 1. Daily management of OR activity 1. Posthoc evaluation of OR activity by analysis of all registered data in balanced scorecards cdd/2004.11

4. Introduction of an OR Information Management System  Operating Room Scheduling and Management Information System  Since january 2001  ZOL : 16 operating theatres / 3 different locations  ORM-m : part of the Yuse Matrix Box = integrated cross-department software package for hospital’s primary care processes  ORM-m : 3 major parts 1. Centralized electronic scheduling of all OR procedures 2. Daily management of all OR activity 3. Posthoc balanced scorecards cdd/2004.11

5. Introduction of an OR Information Management System  Operating Room Scheduling and Management Information System  Since january 2001  ZOL : 16 operating theatres / 3 different locations  ORM-m : part of the Yuse Matrix Box = integrated cross-department software package for hospital’s primary care processes  ORM-m : 3 major parts 1. Centralized electronic scheduling of all OR procedures : OR Planner 2. Daily management of all OR activity 3. Posthoc balanced scorecards cdd/2004.11

11. WHEN CLICKING ON PROCEDURE BLOCK

14. Introduction of an OR Information Management System  Operating Room Scheduling and Management Information System  Since january 2001  ZOL : 16 operating theatres / 3 different locations  ORM-m : part of the Yuse Matrix Box = integrated cross-department software package for hospital’s primary care processes  ORM-m : 3 major parts 1. Centralized electronic scheduling of all OR procedures 2. Daily management of all OR activity : “airport-like screen” 3. Posthoc balanced scorecards cdd/2004.11

15. BLUE + WHITE SCHEDULED PROCEDURE BLUE + BLACK NON SCHEDULED PROCEDURE RED URGENT PROCEDURE YELLOW INFECTED PROCEDURE

16. EXAMPLE OF CONTINUOUSLY UPDATED OR SCHEDULE (Friday 16 February 2001 at 9.00hr)

17. ….. Friday 16 February at 13.00hr

18. ….. Friday 16 February at 14.30 hr

19. Monday 23 October : EXAMPLE OF DYNAMIC RE-SCHEDULING OR PROCEDURE SCHEDULED IN ROOM 1 MOVED TO ROOM 8

20. DYNAMIC RE-SCHEDULING FROM ROOM 3 TO ROOM 6

21. Introduction of an OR Information Management System  Operating Room Scheduling and Management Information System  Since january 2001  ZOL : 16 operating theatres / 3 different locations  ORM-m : part of the Yuse Matrix Box = integrated cross-department software package for hospital’s primary care processes  ORM-m : 3 major parts 1. Centralized electronic scheduling of all OR procedures 2. Daily management of all OR activity 3. Posthoc balanced scorecards cdd/2004.11

22. Total OR activity / campus 2001 (1-2) Total : 22 262 procedures

23. Block-Occupation (scheduled) ZG 2001-1 mean occupation : 95.7% cdd/2004.11 Room 1 2 34 5 6 7 8 Day MONDAYCTVCTVORTNCHABHK/CAHKGYNMKA 97%94%91%121%129%105%84%87% TUESDAYNCH/UROORTNCHABHKCAHKGYNPLHK 106%83%98%112%109%124%95%76% WEDNESDAYCTVCTVORTNCHAHK/UROCAHKGYNGYN 111%98%94%100%56%/84%88%90%96% THURSDAYGYN/ABHKORTNCHABHKCAHKGYNMKA 69%94%92%111%88%119%85%84% FRIDAYCTVCTVNCHNCHABHKCAHKGYN MKA/GYN 112%98%107%101%96%90%90% 98%/85%

25. Block-Occupation (scheduled) ZG 2001-1 mean occupation : 95.7% cdd/2004.11 Room 1 2 34 5 6 7 8 Day MONDAYCTVCTVORTNCHABHK/CAHKGYNMKA 97%94%91%121%129%105%84%87% TUESDAYNCH/UROORTNCHABHKCAHKGYNPLHK 106%83%98%112%109%124%95%76% WEDNESDAYCTVCTVORTNCHAHK/UROCAHKGYNGYN 111%98%94%100%56%/84%88%90%96% THURSDAYGYN/ABHKORTNCHABHKCAHKGYNMKA 69%94%92%111%88%119%85%84% FRIDAYCTVCTVNCHNCHABHKCAHKGYN MKA/GYN 112%98%107%101%96%90%90% 98%/85%

26. Aim of this report  Comparison of “performance” or “efficiency” of all OR activity for elective abdominal surgery for 2000-1 to 2001-1 cdd/2004.11

27. Aim of this report  Comparison of “performance” or “efficiency” of all OR activity for elective abdominal surgery for 2000-1 to 2001-1  No urgent or semi-urgent procedures : only scheduled procedures cdd/2004.11

28. Aim of this report  Comparison of “performance” or “efficiency” of all OR activity for elective abdominal surgery for 2000-1 to 2001-1  No urgent or semi-urgent procedures : only scheduled procedures 20002001 Total available OR time805h805h cdd/2004.11

29. Aim of this report  Comparison of “performance” or “efficiency” of all OR activity for elective abdominal surgery for 2000-1 to 2001-1  No urgent or semi-urgent procedures : only scheduled procedures 20002001 Total available OR time805h805h Operative procedures764815 cdd/2004.11

30.  OR activity for elective abdominal surgery for 2001-1  6.6% increase in number of performed procedures At what expenses ??? cdd/2004.11 OR activity for elective abdominal surgery 2000-1 compared to 2001-1

31. Aim of this report  Comparison of “performance” or “efficiency” of all OR activity for elective abdominal surgery for 2000-1 to 2001-1  No urgent or semi-urgent procedures : only scheduled procedures 20002001 Total available OR time805h805h Operative procedures764815 Total duration of OR procedures1044h50min1127h35min* Total excess time147h20min123h04min* Total unused time46h45min35h21min* cdd/2004.11

32.  OR activity for elective abdominal surgery for 2001-1  6.6% increase in number of performed procedures At what expenses ??? -16.3%* excess OR time excess time defined as realized OR time exceeding the normal limits of OR activity, and inducing extra costs for nursing staff normal OR time at our institution : 8.00 AM to 4.30 PM excess time : OR time > 4.30 PM cdd/2004.11 OR activity for elective abdominal surgery 2000-1 compared to 2001-1

33.  OR activity for elective abdominal surgery for 2001-1  6.6% increase in number of performed procedures At what expenses ??? -16.3%* excess OR time -23%*unused OR time unused OR time defined as OR time during normal activity hours without any procedure performed cdd/2004.11 OR activity for elective abdominal surgery 2000-1 compared to 2001-1

34.  OR activity for elective abdominal surgery for 2001-1  6.6% increase in number of performed procedures At what expenses ??? -16.3%* excess OR time -23%* unused OR time INCOME > > > EXPENSES increased OR performance  How to explain ??? cdd/2004.11 OR activity for elective abdominal surgery 2000-1 compared to 2001-1

35.  -23%* unused OR time  significant reduction in turnover time (time between patient OUT and next patient IN) 2000m12.3min 2001m7.8min* cdd/2004.11 How to explain increased OR performance by introduction of an OR information Management System ?

36.  -23%* unused OR time  significant reduction in turnover time (time between patient OUT and next patient IN) 2000m12.3min 2001m7.8min* possibly due to a reduction in arrival time to OR? 2000m21.3min 2001m14.1min* cdd/2004.11 How to explain increased OR performance by introduction of an OR information Management System ?

37. ….. Friday 16 February at 13.00hr

38.  “management’” of all information OR planner open to electronic surgical bookings Management of all scheduled information Management of patient medical data ànd materials Readily accesible availability of all medical information Management of OR activity during daily practice….. cdd/2004.11 How to explain increased OR performance by introduction of an OR information Management System ?

39. DYNAMIC RE-SCHEDULING FROM ROOM 3 TO ROOM 6

40. Introduction of an OR Information Management System  Operating Room Scheduling and Management Information System 1. Centralized electronic scheduling of all OR procedures 2. Daily management of all OR activity 3. Posthoc balanced scorecards  increased performance of OR activity, with more procedures performed despite less expenses cdd/2004.11