Archive April 2017 XVIII, No. 4

Business Advisor: The Art of the Flip

Ground rules govern when we let surgeons run 2 rooms.

Dan Peterson, MHSA, FACHE

room flipping OVERLAPPING SURGERIES Room flipping lets your surgeons do more cases and, if managed properly, can decrease your staff overtime rates.

Not long ago, flip was a four-letter word at our surgery center, but that's all many of our busier surgeons wanted to do: flip cases in a second operating room. For them, it was all about doing more cases in less time — not sitting in the doctor's lounge waiting for a room to turn over.

We resisted letting our surgeons run 2 rooms for as long as we could, concerned that the long days and the late hours would take a toll on our staff. But we knew that if we didn't let our docs flip rooms, we'd be in danger of losing them to a competitor willing to accommodate them. Two years ago, we finally conceded, but not before working with our docs to set up strict guidelines on when we'd flip rooms. Rather than rush in, we wanted to ensure that overlapping surgeries would be efficient for us as well as for our doctors. Our overriding principle: Be selective. You don't want to flip every doc and every case. Here are 5 factors that help us decide.

1Is case length equal to turnover time? We prioritize flipping for cases where the turnover time is similar to the case duration. It makes sense to flip a 15-minute hand case that has a 10- to 15-minute turnover time because a surgeon can do another hand case in OR 1 while OR 2 is being turned over. On the other hand, it wouldn't make sense to flip knee arthroscopies where case duration is 60 to 90 minutes and turnover time is about 30 minutes. There'd be too much standing around. Our surgeons have learned to book cases that fit our flipping criteria on days when we are most likely to have a second room available. When the surgery is considerably longer than the turnover, they know to book them for the start or end of the day.

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