Surgical staffing is typically determined by precedent or habit, rarely by what the data actually indicate. While this approach will keep your operating room plugging along, it will not do anything to promote efficiency or control costs.
To improve efficiency and reduce costs in the OR, it is necessary to analyze your data. This opens an entire world of insight. Suddenly, it becomes possible to see when numbers of procedures increase, when they remain steady and when delays begin to occur. Costs for staffing at specific times of day or for specific procedures can be tallied and more effective approaches can be devised. Data even make it possible to ensure fairness in call scheduling and holiday assignments for your surgical staff.
Types of Data Needed to Improve Surgical Staffing
A combination of patient, provider and cost data is needed to establish patterns and determine the best approach to staffing your surgical team. Patient data can be pulled from the EHR to give information on what procedures are performed and when they occur. Staff schedules can be used to pull in data on provider work schedule and historical assignments of call and holiday shifts. Time tracking systems provide data on clocking in/out and payroll systems provide data on overtime and incentive pay.
Ideally, your systems will be integrated so it will be easy to find these data in one place.
With all the data assembled, the goal is to determine patterns around patient demand, provider productivity and schedule fairness.
Surgical staffing necessarily fluctuates based on the needs of incoming patients. When you review your data, begin with the big picture. Are there any seasonal variations that you know to expect in your practice? For instance, if you run an orthopedics clinic near a ski resort, winter might see an increase in skiing-related injuries. Similarly, if your practice is in a town that houses retired "snow birds" in the wintertime, you might see an increase related to their needs.
After you have addressed seasonal fluctuations, try to understand your needs across the day. It is not uncommon for surgical units to staff for the absolute worst case scenario every day. Obviously, it is good to be prepared, but that may not be the most efficient, or cost-effective, method of staffing your unit. Use the data to determine what constitutes a representative day in your practice and consider staffing for that. Run the numbers to see if it would be more cost-effective to staff for a typical day and use incentive pay to bring in additional providers when a worst case scenario occurs.
Data analysis will also help you determine whether your expected patient demand would be better served by running more rooms early or fewer rooms later.
Another factor to review is how long each procedure takes, on average. Are there any trends affecting procedure length - for instance, does it vary by provider or time of day? When such patterns arise, they provide a starting point for further investigation. You may discover that the provider with the longest procedure time on a given operation is also the provider taking the most challenging patients. Alternatively, you may find that the turnover process is handled too slowly by that particular provider.
Either way, you have used your data to point you in the direction of improving surgical efficiency.
Patients are, of course, only part of the equation; you also need to consider your providers.
Analyze your payroll data along with your scheduling data to determine if everyone is working their minimum hours. It is not uncommon for healthcare organizations to pay one provider for overtime while another, similarly credentialed provider has yet to be fully utilized. This is one of the biggest cost drains on your operating budget as it has you effectively paying (more than) double for each hour worked.
Data can also be used to determine how late you need to schedule your staff. Consider different types of shifts and see which would best fit both your patient demand and provider needs. For instance, do you need fewer people to run surgeries at 4:00 pm as opposed to 7:00 am? If so, are your staff schedules reflecting that?
Data are also very handy at ensuring fairness in your schedules - and nowhere is that more important than regarding call shifts and time off. Nobody likes to think they are being treated unfairly when it comes to getting vacation or being assigned the most stressful call shifts.
Your data can tell you whether there is any statistical justification for complaints that call schedules are unfair or whether some people are hogging the best call shifts or vacation days.
However, while it can be easy to see if major holidays are being distributed fairly, it is less easy to know if all your different call shifts are being assigned fairly. The easiest solution to this is to use an automated scheduling system that can statistically balance call shifts across the entire year.
Let Your Data Guide Your Surgical Staffing
The secret to better surgical staffing is in the data. A simple analysis will help you determine the most appropriate staff mix for a typical day, what seasonal or daily patterns you need to prepare for, and whether you are using your providers efficiently.
Whatever choices you make, you will have the confidence of knowing the data back up your decision.