Ken Takenaka, M.Ed., ATC, OTC, BCS-O, is director of operations at Orthopedic + Fracture Specialists (Portland, Ore.). In this Q&A, Ken shares how his team rebuilt their surgery scheduling process, improved visibility into their backlog and bottlenecks, and increased throughput, all while making the work easier for schedulers and staff. Ken will expand on this work at the upcoming Transform Perioperative Operations Virtual Summit on February 17.
Question: What challenges pushed Orthopedic + Fracture Specialists to take a hard look at surgery scheduling?
Ken Takenaka: Back in 2024, we faced a number of challenges related to surgery scheduling, specifically around resource utilization. Not all of those factors were within our control. Between hospital shortages and nursing strikes, we had to navigate an ever‑changing landscape.
What we realized pretty quickly was that we had an existing fragility in our business process surrounding surgical scheduling. Surgery is the revenue engine of the practice, and delays and cancellations are extremely costly. It’s also the most important experience for our patients, and any hiccups erode their confidence.
If you don’t measure or monitor this process, the cost of inaction is tremendous. Administrators are often left putting out fires rather than managing productivity.
Question: What did your surgery scheduling process look like before, and why did it stop working as the practice grew?
KT: When I first started here 14 years ago, we didn’t have a formal surgery scheduling department. Our MAs on the clinic floor handled booking while juggling their other responsibilities.
That worked for a while. But as we added more surgeons and the caseload grew, it began to create inefficiencies. Since 2020, we expanded by six additional providers, while our hospital OR resources largely remained stable, at times decreasing due to community factors.
Our traditional workflow – paper binders, phone calls and static spreadsheets – was stretched to its limits. Then staffing shortages, supply chain delays and labor strikes at the hospital disrupted our normal operations, and relying on static schedules and intuition alone just wasn’t viable.
Question: What led you to explore AI-based solutions to support surgery scheduling, and what did you need the technology to solve?
KT: We needed a single source of truth – real‑time visibility into case status, volumes and backlogs – to support our growing demands and to weather disruptions over which we had no control.
That’s what ultimately led us to partner with LeanTaaS and implement iQueue for Surgical Clinics, because the existing tools in our EHR were not adequate, and we wanted to reduce dependency on specialized staff and manual processes, especially with employee turnover.
Before, we relied on binders, scattered spreadsheets and even sticky notes. One scheduler told me there were six different ways she received cases: chat, sticky notes, email, and others. We were always one employee call‑out away from potential disaster. With the platform, every case is visible as soon as it’s entered.
Question: What changed after implementing the new technology, and what results stood out most?
KT: Within weeks of launching, we knew we were never looking back. One of the first major benefits was transparent queues of who’s scheduled, who’s on hold, and who’s ready to move up if a slot opens.
We tracked the average time it takes to schedule a case once a booking request comes in. Before, it took an average of 40 days for a case to make it onto the books. After deployment, that fell by 75% to 10 days, about three times faster. We also started scheduling further out. Pre‑launch, the average lead time was about 23 days. Post‑launch, it’s roughly 32 days, a 39% improvement.
And as we got more efficient, we were able to handle more volume. In the first few months, we saw a 12% increase in surgical case volume, without adding scheduling headcount. Our schedulers went from about 123 cases per month to 162 cases per month each, with room to grow.
Question: Beyond the metrics, what was the most unexpected outcome once you had real‑time visibility into the pipeline?
KT: Before, we didn’t have data. I could give you all the data you wanted about appointments, but the surgical scheduling piece was a black hole.
One of the most unexpected outcomes has been how quickly we can fact check assumptions and solve problems. If someone tells me, “We’re booking way out,” or “This surgeon is completely slammed,” I can log in, pull a report and get a real answer in minutes.
That level of visibility changes the conversation. Instead of relying on anecdotes, we can identify where the real bottleneck is – whether it’s backlog, clearances, authorizations or something else – and then actually do something about it.
Question: What’s next, and what are you most focused on improving as you continue to mature the process?
KT: It took only a couple of months with our new AI‑enabled system to stabilize our workflow. Now that we have the fundamentals in place, we’ve also established a data‑driven pipeline, and some new insights have started to emerge. We’re moving from “get it done” to “do it better.”
At our 90‑day review, we identified 164 stalled cases across eight broad buckets – patients who made it through evaluation and were offered surgery, only to never end up having surgery. We estimate about half were recoverable.
Now we can prioritize follow‑up, help patients navigate insurance and financial hurdles, and make sure medical clearances are completed. In our next phase, we’re focused on shifting from reactive to proactive processes.
Want to hear the full story?
Ken will share additional details, lessons learned and practical takeaways during his session at Transform Perioperative Operations Virtual Summit on February 17, 2026, at 11:00 a.m. CT.
