In the OR, Behind the Scenes Adjustments Make a Big Difference

To address today’s challenges, hospitals are reimagining how they perform certain tasks in the OR

September 28, 2022

By Sheri Voss, MS, RN, CNOR (E)

Precision matters in the operating room. Successful patient outcomes depend on carefully timed procedures, inventory selection, state-of-the-art equipment, and specialized staffing. These precise requirements represent a significant time and cost investment for hospital systems, and those investments are likely to continue to increase.

The height of the COVID-19 pandemic presented considerable supply and labor shortages that continue to challenge healthcare delivery today. It is becoming increasingly clear that these issues are here to stay, and traditional solutions like increasing staff hours and budgets might not be enough to mitigate the problems. Addressing these complex challenges requires leaders to reimagine how they approach perioperative management. Just as precision is essential in perioperative care, it can prove invaluable in solving ongoing difficulties. Devoting specialized resources to specialized problems could be the answer to hospital leaders’ most pressing challenges.

Third-party partners

Hospitals have traditionally worked with and relied on third party partners to provide services outside the OR. Marriott and food service come to mind when thinking of such a partner performing such a service. But increasingly, especially with today’s labor shortages, hospitals are working with third-party partners to outsource services performed in the OR space. Typically, these services are performed by clinicians and don’t directly impact patient care. But they do take up the time of clinicians. Two such examples are suture management and case picking.

Suture Management

While traditionally handled in house, suture management can benefit from a third party partner who can lift a significant burden from an overextended department. Managing sutures can be, and often is, a time consuming task for clinicians that is accomplished by eyeballing inventory and reordering product as they see fit. Periodic analysis is also a task needed to be taken to determine if stock keeping units (SKUs) can be removed or adjusted in any way but consumes precious time for busy clinical staff. A third party has the time and technology resources to track and leverage data to select the best SKUs possible. Having a dedicated third party resource to take ownership of all aspects of suture management, from maintaining the proper inventory levels to ordering product, to expediting shipments, drives cost and time efficiency. The efficiencies gained in suture management enable staff and clinicians to devote less time to supply chain management and devote their time where it matters most—patient care.

Case Picking

Case picking is another area that lends itself to a specialized third party partner. The third party partner works closely with hospital subject matter experts and perioperative leadership to determine the appropriate surgical procedures for the program. Usually more complex, high-volume and supply-intensive procedures are selected. Having a dedicated partner to build a kit to the specifications of the department and that contains nearly everything needed for the case, saves valuable time and streamlines the case picking process. The person picking the case pulls the kit plus any additional items needed for the procedure that are not contained within the kit. Put another way, instead of someone having to devote their time to searching for items that align to certain procedures, they have a tailored kit that contains the specific inventory needed for the agreed upon surgical procedure.

Another benefit of having a dedicated partner to assemble a procedure kit is the streamlining of the returns process. Typically, the partner assists in cleaning up the physician preference cards as changes are made to the procedure kit based on analysis of the data. Changes to the preference cards are recommended based on the data that ultimately results in building a better, more accurate kit. The evaluation and review of consumption data and making appropriate kit changes results in fewer items being returned and decreases staff time associated with re-shelving unused products.

Managing consumables

It’s not just specific case inventory that benefits from dedicated management. Many hospitals traditionally manage consumable items like tubing and bandages on an as-needed basis, relying on a reactive approach that, while functional in the moment, does not ultimately support long-term efficiency or a holistic approach to supply chain management. Some hospitals are reimagining the process of how they manage consumables. These hospitals are typically using a two-bin Kanban solution that places two bins of product on a rack, one right behind the other. When the forward bin becomes empty, the person removes the empty bin, places it on top of the rack signaling a re-order and pulls the rear bin forward. It’s a process that saves time and reduces waste.

Strategic automation should be top of mind for perioperative leaders seeking to mitigate the challenges of management. For delicate items like bone and tissue grafts, automating the tracking process saves time and supports enhanced safety. Instead of relying on manual processes and paper forms, these tasks could be digitized and tracked by a customized technology solution. In addition to live tissue inventory, items as simple as paper bill only purchase orders also have the potential to be digitized for ease of use and for more proactive resource planning.

For hospital leaders who are well-versed in recruiting the best possible in-house talent, relying on a third party partner might seem daunting at first. It shouldn’t be. Start with the OR staff. Ask them what non-clinical tasks they dislike. Then look at tasks not directly related to patient care that clinicians are performing. Case management might be such a task. Or look at non-clinical tasks in the OR that someone should be doing but it’s done on a reactive basis with little thought given to it. Suture management might be one such task. Then talk to your distributor. They often have services that address these problems. And if they don’t, they can generally help you identify companies that do.

This strategic reimagining of traditional perioperative management could make all the difference in addressing the complex issues facing modern departments. After all, an OR runs on intricate, specialized decisions—it makes sense that the perioperative space requires specialized solutions and support.