Predictive analytics is reshaping how hospital surgical teams manage their scheduling. Sam Davis Jr., D.N.P., M.H.A., R.N., associate vice president of perioperative and interventional services at Rush University Medical Center, recently discussed with Healthcare Innovation his role in managing daily operations, focusing on clinical efficiency and collaboration with surgeons, anesthesia partners, and nursing teams, as well as the impact of analytics solutions.
For the past several years, Davis said, Chicago-based Rush has been using LeanTaaS’ iQueue solution to leverage data to overcome some longstanding operating room (OR) challenges.
Healthcare Innovation: Could we start by having you talk about your role as associate vice president of perioperative and interventional services. What kind of issues are you dealing with on a day-to-day basis, and who are you working with most closely?
Davis: In my role I am really focused on clinical efficiency — how well we are operating, how well we’re using our time, making sure that our surgeons have the availability they need. I work closely with our surgeon partners, our anesthesia partners, and our nursing team. That’s the triad that we work with to ensure that we really are being efficient through perioperative services.
HCI: What are some of the types of challenges or inefficiencies that most hospital surgery operations face?
Davis: We were facing issues related to fully allocated blocks not being used, preventing surgeons from putting new cases on the schedule. We were also looking at unpredictability of block usage, which really inhibited our ability to predict appropriate staffing and resource availability. The lack of trusted, accessible data was one big thing that we really had concerns with. We were relying on manual, lagging data and legacy allocation methodology.
HCI: Because you were manually gathering data to help understand what’s going to be available and open during these blocks of surgery time, correct?
Davis: Yes. We didn’t have any predictive analytics. And we realized it was not the most ideal way to look ahead and figure out where we need to be in the future.
HCI: We are following lots of use cases involving machine learning and AI in every aspect of healthcare. What kind of impact is this having on your operations?
Davis: I can go over a few of the key metrics in areas where we’ve seen the most impact. Over the last several years, we’ve seen a 12 times return on investment. We’ve seen a 5% increase in our surgical case volume over the last four fiscal years — from FY 21 to FY 24. That’s about 1,700 additional surgeries. We’ve seen about an 8% increase in our case minutes. So that’s more than 257,000 minutes worth of cases.
We’re really seeing an increase in our ability to use our time within the operating room and being able to work with our physicians. Using that data, we saw a 4% increase in our prime time OR utilization between 7 am and 5 pm. We are really optimizing that time a little bit more than we were before we used AI.
HCI: Is the LeanTaaS solution pulling data from several different sources, including the EHR to make those predictions and identify blocks where you could be more efficient?
Davis: Yes, One reason why we like LeanTaaS is the way that it integrates with our EHR. We use Epic, and LeanTaaS pulls all of that information from Epic and synthesizes that data for us. With the program that we use, it’s able to take all of the information that we’re pulling out of Epic, doing the predictive analytics, and presenting the data in a way that’s meaningful for us. They’ve worked closely with us to develop the presentation of data so that it is really meaningful to all of the key stakeholders. So it’s had a tremendous impact for us.
HCI: Is part of the benefit of this also being able to expedite patient throughput — either to admit patients or send them home after their surgery?
Davis: Absolutely. When we’re talking about throughput on the back end, we are ensuring that we’re working with our inpatient partners and we’re working with the ED, for example, to ensure that we’re using our data to help guide us on how we’re going to be able to get patients through the process efficiently.
One thing that we’re really focusing on now is in our PACU [post-anesthesia care unit] and how we are discharging patients, particularly patients who may need to go to the inpatient units. We are using information from LeanTaaS to help anticipate how many patients are going to need a bed from an inpatient standpoint, and connecting with our inpatient partners so we can reduce the amount of boarding time that we have once patients are out of their surgeries.
HCI: So it sounds like this gives the clinicians themselves a little more autonomy in terms of scheduling. Do you hear anecdotally from them that they like that?
Davis: We do. One of the biggest things that we’ve heard from our physician partners is that they like having that integrated data readily available for them so they can go into the system and see what’s available. We liken it to Open Table. You know, everybody wants that fancy restaurant on Saturday at 6:30 p.m. We know that we can’t give all of them that reservation at that time. So what other time is available that they can request? Our scheduling team works with their teams to find times that are available outside of that prime time that they’re looking for. That transparency is one piece that has really worked well.
HCI: What about scheduling nurses and staff time? Is that in a separate system? How does that all come together?
Davis: One thing that we are looking at from a staffing perspective is working with LeanTaaS to implement our staffing module. That will be able to integrate with our staff scheduling system, to make sure that it’s mirrored exactly with how our schedule is going to be moving forward. That’s a very manual process now that our nursing leaders do, so being able to have that module connected to LeanTaaS is going to have a meaningful impact on how we are scheduling and making sure that we’re utilizing our resources appropriately.
HCI: Are there other ways that you could see automation leading to efficiencies in the operating suites — like filming everything or tracking equipment in new ways?
Davis: We just had a conversation about that this week. One thing that we are looking at is installing cameras in all of our operating suites to give us a better idea of what’s actually happening in real time. If we’re able to have that that information of what’s going on, we’re better able to identify what needs to be done, how we’re doing it, how quickly we’re doing it, and drive efficiency. So that’s one thing that we are looking at.
HCI: Anything else you want to mention about changes you’ve made?
Davis: I think working with LeanTaaS has brought our teams together and changed the perspective on how we view data. In the past, we saw data as being punitive, and now we see it as a more powerful driver for operational success. That’s one thing that really has changed our culture from where we were.
We’ve started daily operational huddles. We’ve started connecting with our surgeons with monthly check-ins. Those are dedicated times for us to go over their scorecard to figure out how they’re meeting their metrics, what’s going well and what’s not going well. It brings together the clinical schedulers, the OR schedulers, and all of our leadership team to have that cross-functional collaboration. Previously, there was a lot of finger-pointing. Now we’re all working together and making sure that we’re on the same page and moving in the same direction.
