ASC Case Scheduling: Best Ideas for Biggest Efficiencies

Scheduling challenges are common for ambulatory surgery centers, whether it's making physicians happy with block times, maximizing OR use with compact scheduling or making sure the patient is ready for their case to start on time.

When done right, scheduling can make a huge impact on the surgery center's reputation and profitability. The schedulers are often the first touch point physician offices and patients have with your center and making it easy to schedule cases is important; however, the lean ASC business model requires ASCs to fill OR time and do whatever they can to bring in more cases.

Build efficient schedules
Therein lies the challenge; bringing in more cases to fill the gaps while also satisfying physicians and their schedulers. There are a few "tricks to the trade" that will help schedulers identify how to organize the schedules most efficiently while still accommodating all other parties. Keep in mind:

•    Cases with longer recovery time are best scheduled as first cases of the day; cases with the shortest recovery time are better in the afternoon.
•    Time in the operating room — this is variable by procedure and even by physician, as some may take longer than others to perform the same procedure. Knowing what to expect on this front will help schedulers schedule efficiently.
•    Which side the surgery is on — this is especially true for orthopedic procedures where it takes longer to turnaround the room if the equipment is set up for surgery on the right side and then switched to the left, and then back again.
•    Expected recovery time — if the recovery bays are backed up, patients will need to wait in the OR and the whole schedule can be disrupted for the day.

Block time
ASC administrators can monitor physician utilization and block scheduling to tailor their OR time effectively. The common benchmark for block time utilization is 70 percent to 90 percent — based on the ASC's situation. When physicians aren't utilizing their block time, discuss the issue with them and potential strategies to increase utilization. Some of the common issues here are:

•    Physician office schedulers are calling other facilities — hospitals or ASCs — first; the surgeon may be able to direct their staff when taking the case to your ASC is best.
•    Scheduling is too hard for physician offices; streamline the process or give them a special line to call that will fast-track their scheduling needs.
•    Block time isn't convenient for the surgeon; perhaps his or her schedule has changed elsewhere and their time at the center needs to be revised.
•    Surgeons have an issue with the center — sometimes surgeons might have a problem but are too busy to address it until the administrator comes to them.

Compact scheduling
One of the most efficient ways to schedule is compact scheduling — scheduling many cases in a row to avoid excessive staff downtime — and when physicians have control of scheduling within their blocks they can group their cases together in a way that works for them, says MedHQ CEO Tom Jacobs, who is also administrator at EndoLabs.

"We have an easier time hitting the profitability benchmark if we have 15 cases scheduled per day," says Mr. Jacobs. "There is a drop-off in profitability if we are over or under that number. We let everyone know that and try to coordinate appropriately."

The center still has time to accommodate special cases and communicates gaps in the schedule to other physicians ahead of time so the space can be filled.

Avoid delays and maximize efforts
Even with the most well-executed OR plan, there will still be days when the schedule doesn't run smoothly. Patients or physicians might be late; cases are cancelled due to an unforeseen event; despite best efforts, there is downtime between cases.

To avoid those situations and maximize their staff, ASC administrators can:

•    Develop a pre-surgical process to ensure as many foreseeable complications are recognized and tests are taken before the day of surgery.
•    Collect patient history ahead of time with online portals.
•    Double-check preauthorization before the day of surgery.
•    Remind patients not to eat before procedures and to bring the appropriate information to the center with a phone call, email or text message; or all three.
•    Surgeons are encouraged to arrive on time; if they are consistently tardy, consider scheduling their cases for later in the day preemptively.
•    Cross train staff to stay busy during downtimes.
•    Send employees home on slow days.
•    Allow for early start times, especially if it's a surgeon already performing cases that wants to add early/late cases onto what they already have.

More Articles on Surgery Centers:
4 Tips for ASCs Setting Up EMR Systems for Audit Success

20 Surgery Centers Expected to Open in 2014

6 Frequent Questions on ASC Benchmarking Answered

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