Hakan Ilkin
Four ways perioperative forecasting can transform the hospital
May 01, 2023
By Hakan llkin
Hospital leaders and managers of surgical services are aware of the drawbacks of the current approach to scheduling. The inability to match staffing levels to demand likely tops this list, but other problems such as appropriate (and data-informed) surgeon time allocation are also challenging for OR managers.
Few hospital leaders, however, understand the full extent of the upside—to their organization, not just the OR—when they modernize their scheduling with perioperative forecasting.
New tools that can properly forecast demand for surgical services deliver more than just increased revenue. Handled strategically, these tools can transform interactions across the hospital or health system. From business development and physician practice management to supply chain management and staffing, modernized perioperative forecasting stands to transform the hospital in these 4 ways:
1. Optimize OR capacity
Traditional OR Scheduling tools provide only a limited ability to predict future schedules, and accuracy drops significantly beyond one week out. What predictive analytics tools add is the ability to identify demand and future openings in that schedule by combining multiple data streams. Instead of extrapolating solely from the OR’s past usage patterns, as traditional methods do, new tools also pull in affiliated surgical clinics’ schedules, clinic-to-surgery conversion rate models, and add-on and cancellation models, generating highly reliable forecasts of OR and perioperative demand weeks to months in advance. These forecasts are overlaid onto staff availability, block releases, and budget requirements in dashboards that can be made accessible to anyone who needs them.
Hospital revenue is where these tools make the most immediate impact. By helping OR managers eliminate “white space” from the OR’s schedule and secure the staffing and other resources necessary to meet additional demand—or to responsibly right-size staffing, with ample advance notice, in times of minimal demand—these tools directly affect this key area of the organization’s overall revenue and help improve surgical access for patients.
2. Nurse staffing and job satisfaction
Nurse staffing is an urgent topic for hospital management, who face dramatic shortages of qualified nurses in the near term as well as in the coming decades. Being able to provide reliable schedules for nurses a month or more out (rather than weeks or even days) is a critical tool for attracting and retaining talent. A JAMA Network analysis of cross-sectional survey data from more than 50,000 registered nurses in the U.S. concluded that health systems must implement strategies to alleviate burnout and avoid staffing shortages. These strategies include “adequate nurse staffing and limiting the number of hours worked per shift” —both of which require reliable forecasts of staffing needs.
On an operational level, knowing in advance what nursing specialties or expertise levels need to be present for a surgery helps leadership plan for the best surgical experience and outcome—and makes the hospital more attractive to surgeons who want to know who will be supporting them in the OR.
3. Physician time allocation
Block scheduling has long been the basic form of allocating operating room time. This form is challenging because it requires balancing established surgeons’ demands on OR time with the demands of new surgeons. Another challenge is that these high-stakes decisions are typically made with stale historical data.
Having an accurate picture of surgical services utilization, a month in advance has a transformative effect on this politically charged process. Accurate forecasts—easily accessed for use in OR committee meetings—establish data-based common ground for future scheduling. With a clear, rational view of the pipeline of demand, surgeons and OR managers alike can plan for optimal utilization whether to right-size time allocation or market unused time to surgeons with demonstrated surgical pipelines.
4. Service line decision-making / strategic prioritization
Strategic efforts do not end with surgeon recruitment. The most sophisticated forecasting tools not only provide a forecasted schedule for the OR, they will consider and overlay associated budgetary, space, and staffing figures. This birds’-eye-view of one of the hospital’s chief profit centers—which can be shared across hierarchy and disciplines—is invaluable in terms of aligning perioperative priorities with enterprise strategic priorities, including the addition or adjustment of specific service lines; optimal supply chain management; and timely, rational budgeting.
Conclusion
Hospitals seeking to plan and act strategically need the tools to do so. New forecasting technologies draw on historical data but also surgical clinic schedules and pertinent models to provide an accurate picture of future surgeries—with adequate temporal perspective. These insights have implications for the hospital’s overall strategic development well beyond simply reducing downtime in the OR.
About the author: Hakan Ilkin is the founder and CEO of BrightHospital which specializes in predictive analytics and forecasting for OR and ERs.
Hospital leaders and managers of surgical services are aware of the drawbacks of the current approach to scheduling. The inability to match staffing levels to demand likely tops this list, but other problems such as appropriate (and data-informed) surgeon time allocation are also challenging for OR managers.
Few hospital leaders, however, understand the full extent of the upside—to their organization, not just the OR—when they modernize their scheduling with perioperative forecasting.
New tools that can properly forecast demand for surgical services deliver more than just increased revenue. Handled strategically, these tools can transform interactions across the hospital or health system. From business development and physician practice management to supply chain management and staffing, modernized perioperative forecasting stands to transform the hospital in these 4 ways:
1. Optimize OR capacity
Traditional OR Scheduling tools provide only a limited ability to predict future schedules, and accuracy drops significantly beyond one week out. What predictive analytics tools add is the ability to identify demand and future openings in that schedule by combining multiple data streams. Instead of extrapolating solely from the OR’s past usage patterns, as traditional methods do, new tools also pull in affiliated surgical clinics’ schedules, clinic-to-surgery conversion rate models, and add-on and cancellation models, generating highly reliable forecasts of OR and perioperative demand weeks to months in advance. These forecasts are overlaid onto staff availability, block releases, and budget requirements in dashboards that can be made accessible to anyone who needs them.
Hospital revenue is where these tools make the most immediate impact. By helping OR managers eliminate “white space” from the OR’s schedule and secure the staffing and other resources necessary to meet additional demand—or to responsibly right-size staffing, with ample advance notice, in times of minimal demand—these tools directly affect this key area of the organization’s overall revenue and help improve surgical access for patients.
2. Nurse staffing and job satisfaction
Nurse staffing is an urgent topic for hospital management, who face dramatic shortages of qualified nurses in the near term as well as in the coming decades. Being able to provide reliable schedules for nurses a month or more out (rather than weeks or even days) is a critical tool for attracting and retaining talent. A JAMA Network analysis of cross-sectional survey data from more than 50,000 registered nurses in the U.S. concluded that health systems must implement strategies to alleviate burnout and avoid staffing shortages. These strategies include “adequate nurse staffing and limiting the number of hours worked per shift” —both of which require reliable forecasts of staffing needs.
On an operational level, knowing in advance what nursing specialties or expertise levels need to be present for a surgery helps leadership plan for the best surgical experience and outcome—and makes the hospital more attractive to surgeons who want to know who will be supporting them in the OR.
3. Physician time allocation
Block scheduling has long been the basic form of allocating operating room time. This form is challenging because it requires balancing established surgeons’ demands on OR time with the demands of new surgeons. Another challenge is that these high-stakes decisions are typically made with stale historical data.
Having an accurate picture of surgical services utilization, a month in advance has a transformative effect on this politically charged process. Accurate forecasts—easily accessed for use in OR committee meetings—establish data-based common ground for future scheduling. With a clear, rational view of the pipeline of demand, surgeons and OR managers alike can plan for optimal utilization whether to right-size time allocation or market unused time to surgeons with demonstrated surgical pipelines.
4. Service line decision-making / strategic prioritization
Strategic efforts do not end with surgeon recruitment. The most sophisticated forecasting tools not only provide a forecasted schedule for the OR, they will consider and overlay associated budgetary, space, and staffing figures. This birds’-eye-view of one of the hospital’s chief profit centers—which can be shared across hierarchy and disciplines—is invaluable in terms of aligning perioperative priorities with enterprise strategic priorities, including the addition or adjustment of specific service lines; optimal supply chain management; and timely, rational budgeting.
Conclusion
Hospitals seeking to plan and act strategically need the tools to do so. New forecasting technologies draw on historical data but also surgical clinic schedules and pertinent models to provide an accurate picture of future surgeries—with adequate temporal perspective. These insights have implications for the hospital’s overall strategic development well beyond simply reducing downtime in the OR.
About the author: Hakan Ilkin is the founder and CEO of BrightHospital which specializes in predictive analytics and forecasting for OR and ERs.